Mrs. HR is a 48 year old whom you have screened for diabetes since she is over 40, and has a family history of diabetes.
You decided to use the A1C test.
Should you tell her she has Type 2 diabetes?
You are correct!
Mrs. HR’s first result is in the diabetes range, however, "a repeat confirmatory laboratory test must be done on another day".
Click here to review the Diagnostic Criteria for Diabetes.
Mrs. HR goes for a repeat A1C early the following week.
Her next A1C is 6.9% - the diagnosis of Type 2 Diabetes is confirmed.
No, not yet.
Mrs. HR’s first result is in the diabetes range, however, "a repeat confirmatory laboratory test must be done on another day".
Click here to review the Diagnostic Criteria for Diabetes.
Mrs. HR goes for a repeat A1C early the following week.
Her next A1C is 6.9% - the diagnosis of Type 2 Diabetes is confirmed.
In the absence of symptomatic hyperglycemia, if a single laboratory test result is in the diabetes range, a repeat confirmatory laboratory test (FPG, A1C, 2hPG in a 75 g OGTT) must be done on another day. It is preferable that the same test be repeated (in a timely fashion) for confirmation, but a random PG in the diabetes range in an asymptomatic individual should be confirmed with an alternate test. In the case of symptomatic hyperglycemia, the diagnosis has been made and a confirmatory test is not required before treatment is initiated. If results of 2 different tests are available and both are above the diagnostic thresholds, the diagnosis of diabetes is confirmed.
To avoid rapid metabolic deterioration in individuals in whom type 1 diabetes is likely (younger or lean or symptomatic hyperglycemia, especially with ketonuria or ketonemia), the initiation of treatment should not be delayed in order to complete confirmatory testing.
2hPG, 2-hour plasma glucose; AlC, glycated hemoglobin; FPG, fasting plasma glucose; OGTT, oral glucose tolerance test; PG, plasma glucose.
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