WHO criteria for the diagnosis of diabetes

1 Symptoms of diabetes plus casual venous plasma glucose

& 11-1 mmol/l. Casual is defined as any time of day without regard to time since last meal. The classic symptoms of diabetes include polyuria, polydipsia, and unexplained weight loss

2 Fasting plasma glucose & 7-0 mmol/l or whole blood

& 6-1 mmol/l. Fasting is defined as no calorie intake for at least 8 hours

3 2 hour plasma glucose & 11-1 mmol/l during oral glucose tolerance test using 75 g glucose load

In the absence of symptoms, these criteria should be confirmed by repeat testing on a different day. If the fasting or random values are not diagnostic, the 2 hour value post-glucose load should be used

Note.

Fasting plasma glucose < 6-1 mmol/l—normal

Fasting plasma glucose & 6-1 and < 7-0 mmol/l—impaired fasting blood glucose

Fasting plasma glucose & 7-0 mmol/l—provisional diagnosis of diabetes; the diagnosis must be confirmed (see above)

Adapted from Diabetes Care 1997;20:1183-1195

Gestational diabetes

This term embraces the criteria for both diabetes and impaired glucose tolerance when discovered during pregnancy (see page 80).

Glucose tolerance tests may also show: Renal glycosuria—this occurs when there is glycosuria but normal blood glucose concentrations; this is a benign condition, only rarely indicating unusual forms of renal disease It is worth issuing these patients with a certificate to prevent them from being subjected to repeated glucose tolerance tests at every medical examination.

Steeple or lag curve—this is described when fasting and two hour concentrations are normal, but those between are high, causing glycosuria; this is also a benign condition, which most commonly occurs after gastrectomy but may occur in healthy people.

Impaired glucose tolerance

This is defined in the table. Patients are managed at the discretion of the physician. In general, no treatment is given to

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