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Nutrition & Product Information
Diabetes Mellitus & Dairy Food Consumption
Diagnostic Criteria for Diabetes Identification
The prevalence of diabetes depends on the diagnostic criteria used for identification. The newest criteria are those of the American Diabetes Association(ADA).3 These are modifications of those previously recommended by the NDDG5 or WHO.6 These criteria are shown in Table 2. The ADA expert committee recognized that there may be deviants in people who fail for one or another reasons to meet these criteria yet may not be considered normal. This group is defined as having fasting blood glucose levels 110 mg/dl (6.1 mmol/L) but <126 mg/dl (7.0 mmol/L) or 2-hour values in the oral glucose tolerance test of 140 mg/dl (7.8 mmol/L) but <200 mg/dl (11.1 mmol/L). People who fall into this category have impaired glucose tolerance, but are not yet considered to have diabetes. They may progress to diabetes or may remain impaired and never progress to diabetes.
There are additional groupings of people with diabetes that refer to specific circumstances. One is impaired glucose tolerance that may or may not proceed into type 2 diabetes. The other is the diabetes that develops during pregnancy (gestational diabetes) that either disappears after pregnancy or goes on as type 2 diabetes. In each of these instances, the patient is managed as though they were diabetic. Careful attention is paid to the diet as well as to physical activity. As gestation proceeds, some women may require insulin supplements, but the physician will monitor this very carefully. Most obstetricians will observe the growth and development of the fetus and terminate the pregnancy as soon as it is apparent that the fetus can be delivered (by caesarian usually) and will do well. By paying careful attention to this problem, it is hoped that the unusually large baby can be avoided as well as the problem of neonatal hypoglycemia. Neonatal hypoglycemia is a response to the mother’s inability to fully use glucose; the fetus islet cells respond to this by producing insulin in amounts larger than needed. When the child is born, this insulin production must be down-regulated to avoid the potentially dangerous hypoglycemia that could develop.
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Table 2.
Criteria for the Diagnosis of Diabetes Mellitus 3
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- Symptoms of diabetes plus casual plasma glucose concentration 200mg/dl (11.1 mmol/L). Casual is defined as any time of day without regard to time since the last meal. The classic symptoms of diabetes include polyuria, polydipsia, and unexplained weight loss.
OR
- Fasting blood glucose 126mg/dl 7.0 mmol/L). Fasting is defined as no energy intake for at least 8 hrs.*
OR
- 2 hour plasma glucose 200 mg/dl (11.1 mmol/L) during an oral glucose tolerance test.* The test should be performed as described by WHO 6 using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.
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*These measures should be repeated on a different day to confirm diagnosis
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