Diabetes is a chronic health condition that affects millions of people worldwide, and that is often diagnosed with the World Health Organization (WHO) diabetes diagnostic criteria. Diabetes is characterised by high blood sugar levels, which can lead to various complications if not managed properly. Living with diabetes requires a deep understanding of the condition, constant monitoring of blood sugar levels, making informed decisions about nutrition, and managing medications to ensure better health and well-being. This article aims to educate patients about diabetes, its types, symptoms, causes, and the diabetes diagnostic criteria used in the UK by healthcare professionals.
Type 1 or Type 2 Diabetes
There are two main types of diabetes: Type 1 and Type 2. Type 1 diabetes is usually diagnosed in children and young adults, and it occurs when the body’s immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. This leaves the body unable to produce enough insulin to regulate blood sugar levels.
On the other hand, Type 2 diabetes is more common and generally develops in adults over the age of 40, although it is increasingly being diagnosed in younger individuals. In this case, the body either doesn’t produce sufficient insulin or resists its effects, leading to poor blood sugar regulation. Less common types of diabetes include Type 3 diabetes and Gestational diabetes. More information about the different types of diabetes can be found on the NHS website.
WHO Diabetes Diagnostic Criteria
Diagnosing diabetes can be challenging, as the symptoms may vary and can often go unnoticed in the early stages. However, early diagnosis and prompt treatment are crucial to prevent any long-term complications. Some common symptoms include increased thirst, frequent urination, unexplained weight loss, blurry vision, and fatigue.
Healthcare professionals typically use a combination of blood tests, as well as clinical history, to diagnose diabetes. These tests measure the amount of sugar in the bloodstream and assess the body’s ability to process glucose. Based on the test results and other clinical factors, the appropriate diagnosis and treatment plan are established. The most commonly used diagnostic criteria in the UK are the WHO diabetes diagnostic criteria.
These criteria include:
- The presence of symptoms: These include the appearance of classic diabetes symptoms such as increased thirst, frequent urination, unexplained weight loss, fatigue, and blurry vision.
- Fasting plasma glucose: A fasting plasma glucose test measures blood sugar levels after an overnight fast. A level equal to or higher than 7.0 mmol/L (126 mg/dL) on two separate occasions may indicate diabetes.
- 2-hour plasma glucose: Also known as the oral glucose tolerance test, this assessment measures blood sugar levels two hours after consuming a glucose solution. A level equal to or higher than 11.1 mmol/L (200 mg/dL) on two separate occasions suggests diabetes.
- Random plasma glucose: This test is conducted without consideration of the last meal. A blood sugar level equal to or higher than 11.1 mmol/L (200 mg/dL) coupled with classic symptoms of diabetes points to a possible diagnosis.
- Glycated haemoglobin (HbA1c): The HbA1c test reflects an average blood sugar level over the past two to three months. A level equal to or higher than 6.5% (48 mmol/mol) on two separate occasions is suggestive of diabetes.
If you are experiencing symptoms related to diabetes, a single abnormal HbA1c or fasting plasma glucose level can be used to identify possible diabetes. However, it is recommended to undergo repeat testing to confirm the diagnosis. This repeat testing is especially important if there are no symptoms present. Ideally, the same test should be used for repeat testing. If the repeat test results come back as normal, your healthcare provider may arrange for regular monitoring to keep a close eye on the potential development of diabetes. The frequency of monitoring will be determined based on your healthcare provider’s judgement.
It is important to note that a combination of these tests, clinical evaluation, and careful assessment of symptoms by a healthcare professional is necessary for an accurate diagnosis of diabetes. Additionally, further tests may be conducted to differentiate between diabetes types.
HbA1c: Interpret With Caution
HbA1c should not be used to diagnose diabetes mellitus in specific groups, including:
- Children and young people less than 18 years of age
- Pregnant women or women 2 months postpartum
- People with diabetes symptoms for less than 2 months
- People at high diabetes risk who are acutely ill
- People taking medication that may cause hyperglycemia, e.g., long-term corticosteroid treatment
- People with acute pancreatic damage, including pancreatic surgery
- People with end-stage renal disease (ESRD)
- People with HIV infection
HbA1c should be interpreted with caution in people with abnormal red blood cell turnover or abnormal hemoglobin type, such as:
- Abnormal hemoglobin, like hemoglobinopathy
- Severe anemia (any cause)
- Altered red cell lifespan (e.g., post-splenectomy)
- A recent blood transfusion
Conclusion
In conclusion, the WHO diabetes diagnostic criteria can be used by healthcare professionals to accurately identify and diagnose diabetes. These guidelines ensure that individuals with diabetes receive timely and accurate diagnoses, enabling them to access appropriate treatment and better manage their condition. It is essential for individuals to be aware of the WHO diagnostic criteria and work closely with their healthcare providers to monitor their health and take proactive steps in managing their diabetes effectively. With early detection and appropriate management, individuals with diabetes can lead empowered and healthy lives.
For further advice and guidance you can visit: Diabetes UK – Know diabetes. Fight diabetes.
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