Diabetes mellitusun tanı ve izlem kriterleri

Year 2012, Volume: 29 Issue: 1s, 2 - 6, 21.06.2012

Ayşegül Atmaca

Abstract

Diabetes mellitus (DM); Tip 1 DM, Tip 2 DM, başka nedenlere bağlı özel diyabet tipleri ve gestasyonel DM olarak 4 gruba ayrılır. Açlık plazma glukozu (APG) ≥126 mg/dL, 75 g oral glukoz tolerans testinin (OGTT) 2. saatinde bakılan plazma glukozu ≥200 mg/ dL veya HbA1C ≥%6,5 ise sonuçların bir kez daha doğrulanması koşuluyla DM tanısı konabilir. Hiperglisemi semptomlarının varlığında rastgele bakılan plazma glukozunun ≥200 mg/dL olması da tanı koydurucudur. Bu durumda testin konfirme edilmesine gerek yoktur. Gestasyonel DM için 24-28. haftalarda yapılan 75 g OGTT’de APG ≥92 mg/dL veya 1.saat plazma glukozu ≥180 mg/dL veya 2. saat plazma glukozu ≥153 mg/dL olması tanı koydurucudur. DM tanısı alan gebe olmayan hastalarda glisemik kontrol hedefleri HbA1C için <%7, APG için 70-130 mg/dL ve tokluk plazma glukozu için <180 mg/ dL’dir. Ancak bu hedefler DM süresi, hipoglisemi sıklığı, kardiyovasküler hastalık varlığı ve yaşam beklentisi gibi faktörlere göre kişiselleştirilebilir. Gestasyonel DM’de glisemik kontrol hedefleri ise; preprandiyal plazma glukozunun ≤95 mg/dL ve 1.saat postprandiyal plazma glukozunun ≤140 mg/dL veya 2. saat postprandiyal plazma glukozunun ≤120 mg/ dL olmasıdır.

Criteria for diagnosis and follow-up diabetes mellitus

Diabetes mellitus (DM) is classified into 4 groups as Type 1 DM, Type 2 DM, other specific types of diabetes and gestational DM. Fasting plasma glucose (FPG) ≥126 mg/dL, 2–hour plasma glucose during a 75 g oral glucose tolerance test (OGTT) ≥200 mg/dL and HbA1C ≥6.5% establishes the diagnosis of DM, provided that the results are confirmed at another time. In a patient with classical symptoms of hyperglycemia, a random plasma glucose ≥200 mg/dL also establishes the diagnosis. In such a case, there is no need to confirm the diagnosis at another time. The diagnosis of gestational DM is made when any of the following criteria are met during a 75 g OGTT at 24-28 weeks of gestation: FPG ≥92 mg/dL or 1-hour plasma glucose ≥180 mg/dL or 2-hour plasma glucose ≥153 mg/dL. HbA1C <7%, FPG 70-130 mg/dL and postprandial plasma glucose <180 mg/dL are glycemic goals for nonpregnant adults. However, these goals may be individualized based on the duration of DM, occurence of hypoglycemia, presence of cardiovascular disease and life expectancy. Preprandial plasma glucose ≤95 mg/dL and 1-hour postprandial plasma glucose ≤140 mg/dL or 2-hour postprandial plasma glucose ≤120 mg/dL are glycemic goals for gestational DM.

J. Exp. Clin. Med., 2012; 29:S2-S6

Keywords

Diabetes mellitus; Glisemik kontrol; Sınıflandırma; İzlem kriterleri ( Diabetes mellitus; Glycemic control; Classification; Follow-up criteria)

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