ABSTRACT
The European Diabetes Policy Group 1998-1999 have produced
straightforward guidelines1 and a diagnostic algorithm for diabetes
mellitus (Fig 13).
Cautions Diagnosis must be confirmed by laboratory plasma glucose
readings;
The diagnosis must be based on two abnormal glucose
concentrations in the absence of symptoms;
Diagnostic procedures should not be performed in the setting of
acute illness, trauma or surgery or when the patient is on a short
course of blood glucose-raising medication;
Diagnostic tests should be interpreted with caution in patients
taking drugs with hyperglycaemic properties or with treatable
endocrine conditions (Cushing’s syndrome, acromegaly);
If the suspicion of diabetes is high but fasting glucose
concentrations are normal, then an oral glucose tolerance test
(OGTT) should be performed;
If there are normal fasting but raised post-prandial glucose
readings, then diagnosis should be according to 2-hour OGTT
criteria;
Gestational diabetes (diabetes first diagnosed in pregnancy) is an
entity in its own right. Even if the OGTT returns completely to
normal after childbirth, these subjects have an increased risk of
developing type 2 diabetes in later life.
