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Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...

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A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
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Gestational diabetes screening: the low-cost algorithm.

Mukesh M Agarwal1, Bernhard Weigl, Moshe Hod

  • 1Department of Pathology, Faculty of Medicine, UAE University, Al Ain, United Arab Emirates.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|November 22, 2011
PubMed
Summary
This summary is machine-generated.

Fasting plasma glucose (FPG) testing can simplify gestational diabetes mellitus (GDM) screening. This approach could reduce the need for oral glucose tolerance tests (OGTTs), making GDM diagnosis more accessible globally.

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommends universal oral glucose tolerance testing (OGTT) for gestational diabetes mellitus (GDM) screening.
  • This recommendation, endorsed by the American Diabetes Association, involves a complex algorithm that can be burdensome.

Purpose of the Study:

  • To evaluate the efficacy of fasting plasma glucose (FPG) testing and emerging technologies in simplifying the IADPSG GDM screening algorithm.
  • To determine if FPG thresholds can efficiently rule in or rule out GDM, reducing the need for OGTTs.

Main Methods:

  • Utilized the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort (n=23,316) and a high-risk GDM population (n=10,283).
  • Applied two FPG thresholds (≥ 5.1 mmol/L to rule in GDM, ≤ 4.4 mmol/L to rule out GDM) to assess diagnostic performance.
  • Calculated the potential reduction in OGTTs needed based on FPG results.

Main Results:

  • An FPG threshold of ≥ 5.1 mmol/L ruled in GDM with 100% specificity in both cohorts.
  • An FPG threshold of ≤ 4.4 mmol/L ruled out GDM with 84.1% sensitivity in the HAPO cohort and 95.4% sensitivity in the high-risk cohort.
  • Implementing FPG testing could have avoided 57.0% and 50.6% of OGTTs in the respective study groups.

Conclusions:

  • Initial FPG testing can significantly reduce the number of OGTTs required, potentially increasing global acceptance of GDM screening recommendations.
  • The number of GDM cases missed by FPG screening is population-dependent.
  • Developing cheaper, alternative tests is crucial for low-resource settings.