Diagnostic Tests for Impaired glucose tolerance
Impaired glucose tolerance: Diagnostic Tests
The list of diagnostic tests
mentioned in various sources as
used in the diagnosis of Impaired glucose tolerance
includes:
Impaired glucose tolerance Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Impaired glucose tolerance:
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Impaired glucose tolerance Diagnosis: Book Excerpts
Diagnosis of Impaired glucose tolerance: medical news summaries:
The following medical news items
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Diagnostic Tests for Impaired glucose tolerance: Online Medical Books
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for more information about the diagnostic tests for Impaired glucose tolerance.
GLYCOSURIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
The investigation of glycosuria should include a glucose tolerance test, chemistry panel, and electrolyte panel. If there are clinical features of an endocrine disorder, the various tests for these disorders should be ordered.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
HYPERGLYCEMIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Further workup may include a CBC, urinalysis, chemistry panel, glucose tolerance test, plasma cortisol, free T
4
, TSH, plasma and urine catecholamines, skull x-ray,
vanillylmandelic acid (VMA)
, and endocrinology consult.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Diabetes Mellitus:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
Patients often present with similar physical findings in both type 1 and type 2 DM, owing to hyperglycemia. In the young child, failure to grow and gain weight can occur with type 1 DM. The child may be ill appearing, lethargic, and often have signs of dehydration (tachypnea, tachycardia, and low blood pressure). Ketone production will produce a fruity odor on the patient’s breath. The patient with type 2 DM tends to be obese (especially upper body obesity) and may appear fatigued and have muscle weakness or decreased vision. The neurologic examination may reveal painful feet and numbness. Monilial infections may be found in the vagina and pubic areas.
Testing
A. Type 1 diabetes. Not all children with hyperglycemia have diabetes. Some children with a severe illness (e.g., severe dehydration from diarrhea or asthma treated with corticosteroids) may have elevated serum glucose and ketosis. If the diagnosis is uncertain, a low serum insulin level along with hyperglycemia supports the diagnosis of DM and excludes all other diagnoses. Elevated glycosylated hemoglobin provides a strong circumstantial case for the diagnosis of DM, but it is not used alone for the diagnosis. Performing a glucose tolerance test is rarely necessary. However, it is imperative to obtain insulin levels along with the blood glucose values when it is performed.
B. Type 2 diabetes. The American Diabetes Association (ADA) diagnostic criteria for type 2 DM are either (a) symptoms of diabetes and a casual plasma glucose level of 200 mg/dl or greater, (b) a fasting plasma glucose level of 126 mg/dl or greater, or (c) a plasma glucose level of 200 mg/dl or greater 2 hours after an oral glucose load (75 g). A “casual” plasma blood glucose level is obtained at any time of the day without regard to the time of the last meal, and a “fasting” level is obtained after a fast of at least 8 hours. If the only criterion is hyperglycemia, confirmation should be made on a different day (1).
Diagnostic assessment
The presence of polyuria, polydipsia, polyphagia, and weight loss along with hyperglycemia and ketosis are sufficient to establish the diagnosis of type 1 DM. This provides an ample basis for beginning insulin therapy. Hyperglycemia can also occur during a severe illness. Therefore, the diagnosis of type 1 DM is not always clear. Low insulin levels may be needed to make the diagnosis. The key to the diagnosis of type 2 DM is the detection of hyperglycemia. Patients with symptoms of diabetes should have testing according to the ADA recommendations. Once the diagnosis is made, formulate a treatment program with the patient.
References
1. American Diabetes Association. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997;20:1183–1197.
2. National Diabetes Data Group. Diabetes in America, 2nd ed. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1995. NIH publication 1468-1995.
3. Baker JR. Autoimmune endocrine disease. JAMA 1997;278:1931–1937.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
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