Type 1 Diabetes is a condition in which the body loses its ability to make insulin. Insulin is a hormone that is produced by the pancreas and is needed by the body to use the glucose that is taken up from food. If there is no insulin, the body cannot use glucose, causing levels to go up in the blood. If glucose levels stay very high and are not corrected, Diabetic Ketoacidosis (DKA) may result. The only treatment for this type of diabetes is insulin.
Type 2 Diabetes is a condition in which there is insulin but the body does not respond to it very well. It is the most common type of diabetes, making up 85% of all cases of diabetes and is strongly related to being overweight or obese. Treatment includes a healthy diet and exercise to control weight, as well as tablets, including those that make the body more sensitive to insulin. With time, some people with type of diabetes might need insulin.
DIAGNOSIS OF DIABETES
Fasting blood glucose > 7.0 mmol/L (126 mg/dL)
Blood glucose 2-hours after a meal > 11.1 mmol/L (200 mg/dL)
HbA1C > 6.5%
TARGETS IN DIABETES
Fasting blood glucose: 4.4 - 7.2 mmol/L (80 - 130 mg/dL)
Blood glucose 2-hours after a meal: < 10.0 mmol/L (180 mg/dL)
HbA1C < 7.0% (< 8.0% if elderly or with cardiac problems)
Gestational Diabetes is a condition in which diabetes only comes with pregnancy and goes away after delivery. It is important because it if the high blood glucose levels can cause problems in pregnancy and during delivery for both the mother and the baby. It is diagnosed in the second half of pregnancy by an oral glucose tolerance test (OGTT). Treatment includes a healthy diet and appropriate exercise. If blood glucose levels are still high, then insulin may be needed until the time of delivery.
DIAGNOSIS OF GESTATIONAL DIABETES
To do a 75-g OGTT at 24-28 weeks of pregnancy:
Fasting blood glucose > 5.1 mmol/L (92 mg/dL)
Blood glucose at 1-hour > 10.0 mmol/L (180 mg/dL)
Blood glucose at 2-hours > 8.5 mmol/L (153 mg/dL)
TARGETS IN GESTATIONAL DIABETES
Fasting blood glucose: < 5.3 mmol/L (95 mg/dL)
Blood glucose 1-hour after a meal: < 7.8 mmol/L (140 mg/dL)
Blood glucose 2-hours after a meal: < 6.7 mmol/L (120 mg/dL)
Prediabetes is a condition in which the person does not have diabetes but is at a high risk to get it in the future. The blood glucose levels are not in the diabetes range but are very close to it. Important steps to prevent prediabetes from becoming diabetes are a healthy diet, exercise and weight control if obesity is present. If the blood glucose levels go into the diabetes range, then like diabetes, treatment must be started.
DIAGNOSIS OF PREDIABETES
Fasting blood glucose: 5.6 to 6.9 mmol/L (100 to 125 mg/dL)
Blood glucose 2-hours after a meal: 7.8 to 11.0 mmol/L (140 to 199 mg/dL)
HbA1C: 5.7 to 6.4%
NO DIABETES or PREDIABETES
Fasting blood glucose < 5.6 mmol/L (100 mg/dL)
Blood glucose 2-hours after a meal < 7.8 mmol/L (140 mg/dL)
HbA1C < 5.7%
* Standards of Medical Care in Diabetes, ADA, 2015