DIABETES MELLITUS Current diagnostic criteria Diabetes symptoms (polyuria, polydipsia, unexplained weight loss) plus: – Random venous plasma glucose 200 mg/dl or – Fasting venous plasma glucose 126 mg/dl or – 2 hour venous plasma glucose 200 mg/dl (after 75 g glucose in OGTT) No symptoms: at least two glucose tests on different days within diabetic range WHO definition, diagnosis and classification of diabetes mellitus and its complications.

Classic symptoms of Diabetes Excess urine (Polyuria), Excess drinking water (Polydipsia), Recent weight loss, Blurring of vision, Genital infection – Balanoposthitis in man, – Vulvovaginitis in women.

Fasting and Random FASTING – Overnight fast, – Sample in the morning, – No diet restriction, – Venous blood. RANDOM – Anytime of the day, – Helpful for epidemiological purpose, – No diet restriction, – Venous blood.

GTT - Diagnostic Criteria Normal – 2h value <140 mg Borderline – 2h value 140 – 199 mg Diabetes – 2h 200 mg or more.

Glucose Tolerance Test - Procedure Normal diet for at least 3 days, Overnight fasting, Blood sample for fasting glucose, 75 Gm glucose in 300 ml water to drink over 5 min, Blood sample after 2hr for glucose, Delayed breakfast. Should not be admitted, No smoking Free from stress Six wks from significant medical illness.

Why the diagnose delayed? Awareness is sub- optimum, Negligence, Economic restraint, Access to medical service, Non-specific presentation.