The 5 Rs for all patients with diabetes
Recognize is your reminder to consider diabetes risk factors for all of your patients, and screen appropriately for type 2 diabetes.
Does this mean…
I have to do a bloodtest on everyone? NO
OR, that I have to look for type 2 diabetes risk factors in everyone? YES
Who should I screen?
Screen every 3 years in individuals > 40 years of age or in individuals at high risk using a risk calculator. Screen earlier and/or more frequently in people with additional risk factors for diabetes or for those at very high risk using a risk calculator.
What are the numbers?
| Test | Result | Dysglycemia category |
|---|---|---|
| FPG (mmol/L) No caloric intake for at least 8 hours | 6.1 - 6.9 | IFG |
| ≥7.0 | Diabetes | |
| 2hPG in a 75 g OGTT (mmol/L) | 7.8 - 11.0 | IGT |
| ≥11.1 | Diabetes | |
| A1C (%) Standardized, validated assay, in the absence of factors that affect the accuracy of A1C and not for suspected type 1 diabetes | 6.0 - 6.4 | Prediabetes |
| ≥6.5 | Diabetes | |
| Random PG (mmol/L) | ≥11.1 | Diabetes |
If asymptomatic, a repeat confirmatory test (FPG, A1C, or a 2hrPG in a 75 g OGTT) must be done. If symptomatic, diagnosis made, and begin treatment.
But, how do I actually do this in my practice?
- If you have an Electronic Medical Record (EMR), program alerts to remind you to screen your patients for type 2 diabetes, or,
- Populate this registry template with your patients
- And stay tuned as we develop more EMR templates to facilitate diabetes care
- No EMR? No problem…
- Ask your patients to complete a CANRISK questionnaire while they are waiting for their appointment with you, and ask them about their result when they see you
- Keep this quick reference for screening and diagnosis posted where you will see it in your examination room
Category Tags: Definition, Classification & Diagnosis, General Tips, Management, For Health-care Providers;