Open AccessEvidence for current diagnostic criteria of diabetes mellitus
Author(s) -
Ramesh Kumar,
Lakshmana Perumal Nandhini,
Sadishkumar Kamalanathan,
Jayaprakash Sahoo,
M Vivekanadan
Publication year - 2016
Publication title -
world journal of diabetes
Language(s) - English
Resource type - Journals
ISSN - 1948-9358
DOI - 10.4239/wjd.v7.i17.396
Subject(s) - medicine , prediabetes , diabetes mellitus , concordance , glycemic , intensive care medicine , diabetic retinopathy , impaired fasting glucose , impaired glucose tolerance , endocrinology , type 2 diabetes
Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.