Diabetes mellitus diagnostic criteria

clinical presentation

paraphrased from CKS

  • Optional: polydipsia, polyuria, blurred vision, unexplained weight loss, recurrent infections, and tiredness
  • Acanthosis nigricans (a skin condition causing dark pigmentation of skin folds, typically the axillae, groin, and neck) suggests insulin resistance

investigations

  • HbA1c > 48 (6.5%)
  • Random glucose > 11.1 if symptomatic
  • If asymptomatic, repeat testing
  • Fasting glucose > 7.0
    Same thresholds for kids

limitations of HbA1c

  • Age <18
  • Pregnant women or women who are 2 months postpartum. 
  • People with symptoms of diabetes for less than 2 months. 
  • People at high diabetes risk who are acutely ill.
  • People taking medication that may cause hyperglycaemia (for example long-term corticosteroid treatment). 
  • People with acute pancreatic damage, including pancreatic surgery.
  • People with end-stage renal disease