Diagnosis criteria for DM type 2 Screening for DM type 2

A group of metabolic disorders sharing the common underlying feature of hyperglycemia

Type 1 : absolute deficiency of insulin caused by pancreatic -cell destruction (10% of cases) Type 2 : combination of peripheral resistance to insulin action and an inadequate secretory response by the pancreatic -cell Gestational Diabetes Others

Insulin Resistance

Compensat -ory cell hyperplasia

cell failure (early) = IGT

Primary cell failure (rare)

Diabetes

cell failure (late)

Anamnesis:
Polyuria Polydipsia Polyphagia Weight Loss Fatigue or weakness

Physical Exams
Hypertension obesity

Laboratory:
1. A1C 6.5% 2. FPG 126 mg/dl 3. Two-hour plasma glucose 200 mg/dl during an OGTT 4. Random plasma glucose 200 mg/dl

Screening for diabetes should be done to those with high risk of having DM

Obesity (BMI 25 kg/m2 ) Age > 45 years old Physical inactivity Family history of DM High risk ethnic Hypertension HDL cholesterol level < 35mg/dl or triglyceride level > 250 mg/dl History of CVD Women who delivered a baby weighing >4 kg or were diagnosed with GDM

Education Nutritional therapy Physical activity Pharmacologic intervention Therapy monitoring

Cardiovascular disease Nephropathy Retinopathy Neuropathy