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afya Diagnosis and risk factors

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20160425222352 Ben  
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5% IFG progress to diabetes each year (40% of IFG and IGT progress)
high BMI is more significant than FH

''Metabolic syndrome definition''
central obesity - waist >94 men (>90 asian) >80 women
with 2 or more of
Triglyceride >1.7
HDL <1.03 men 1.29 women
BP >130/85 or pt on Rx
fasting glc >5.6 or on Rx

''To diagnose ...''
Fasting >7.0 or random (or 2hr post 75g glc) >11.1
If aSx - needs these readings on 2 occasions
OR HbA1C >6.5% (48) - diagnostic (below that doesn't exclude it) - beware inc red cell turn over
HbA1C6.0-6.4 (42-47) diagnoses pre-diabetes

Impaired fasting glucose - 6.1-7.0
Impaired glucose tolerance -  2hr post 75g load glc - 7.8-11.1
to diagnose diabetes in aSx pt - need 2 abN readings

Risk - male, black caribbean/Indian

''Inc red cell turnover'' (can't use HbA1C to diagnose)
haemoglobinopathies
haemolytic anaemia
untreated iron deficiency anaemia
suspected gestational diabetes
children
HIV
CKD