Internal Medicine
Curricular Elements:
  Return to Internal Medicine Home Page
  Case I
  Case II 
  Case III
  Adult Vaccination
  Cancer Screening
  Diabetes Screening


 Diabetes Mellitus





Criteria for the diagnosis of diabetes mellitus


Who should be screened for diabetes?


Any of the following:

Symptoms of diabetes (polyuria, polydipsia, unexplained weight loss) plus a casual plasma glucose concentration
> 200 mgldL


A fasting plasma glucose concentration > 126 mg/dL (measured after at least 8 hours of no caloric intake)


An abnormal oral glucose tolerance test result (a plasma glucose concentration  200 mg/dL 2 hours after a glucose load of 75 grams of anhydrous glucose dissolved in water).














Consider testing all persons age 45 and older (if normal, repeat every 3 years)

Consider testing at a younger age, or more frequently, for any of the following:

Obese persons
120% desirable body weight or body mass index = 27 kg/m

First-degree relatives of persons with diabetes

Members of high-risk ethnic groups (eg, African American, Hispanic, Native American)

Mothers of babies weighing>9 lb at birth

Women with a history of gestational diabetes

Hypertensive patients ( 140/90 mm Hg)

Dyslipidemic patients (HDL cholesterol  35 mgldL or triglyceride  250 mgldL or both)

Patients with previous findings of impaired glucose tolerance:
(140-199 mg/dL on 2-hour test) or impaired_fasting_glucose_(110-125_mg/dL)

Not recommended for routine clinical use.

In the absence of unequivocal hyperglycemia with acute metabolic decompensation, these criteria should be confirmed by repeat testing on another day.

Not recommended for routine clinical use.