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THE EARLY RECOGNITION OF DIABETES MELLITUS *

S. Fajans, J. W. Conn
Published 1959 · Medicine

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Progressively earlier recognition of the diabetic state is vital if progress is to be made toward the eventual control and prevention of the disease. The presence of mild diabetes mellitus may remain unrecognized in a large number of individuals for many years unless diagnostic laboratory procedures are freely employed in groups of individuals in whom experience has shown a high incidence of latent diabetes. Dependable diagnostic criteria are now available that make it possible to detect these previously unsuspected diabetic individuals. In addition, it is hoped that other means for detection of the diabetic state will be discovered that will give earlier evidence of its existence than is possible by present methods of testing. This discussion has two purposes, first, to consider the use and the criteria for the interpretation of the standard oral glucose tolerance test employed for the early detection of diabetes and second, to consider experience with the cortisone-glucose tolerance test as used for the possible prediction of future diabetes mellitus. The early recognition of diabetes mellitus depends upon the use and interpretation of proper laboratory procedures. In some cases the presence of latent diabetes will be recognized by routine performance of urinalysis and the determination of a single blood sugar level. In the mildest forms of the disease these procedures may be of little aid. In these cases the earliest recognizable abnormality may be a diminished ability to utilize a carbohydrate load as demonstrated by a glucose tolerance test. We have used the oral glucose tolerance test in our studies. For a t least 3 days preceding the test the subjects ingest a diet containing approximately 300 gm. carbohydrate per day plus maintenance calories.' Although the ingestion of smaller amounts of carbohydrate is sufficient to prevent abnormal tests in normal subjects, a standardized high-carbohydrate preparatory diet is advised to ensure the reproducibility of the test. The loading dose of glucose used is 1.75 gm./kg. of ideal body weight. Blood sugar levels are determined in venous blood by the Somogyi-Nelson technique. The criteria that we employ for the interpretation of the standard oral glucose tolerance test are illustrated in FIGURE 1.2 Carbohydrate tolerance is considered to be normal when the peak blood sugar value is less than 160 mg./ 100 ml. and the 2-hour value is less than 110 mg./100 ml. We regard the combination of an 1-hour value of 160 mg./100 ml. or above plus a 2-hour value of 120 mg./100 ml. or above as diagnostic of the existence of the diabetic state. In borderline curves the level a t 1% hours is required to be 140 mg./100 ml. or above to be diagnostic. This restriction eliminates a false diagnosis of
This paper references



This paper is referenced by
10.2337/diab.28.7.686
Thin Muscle Capillary Basement Membranes in Myotonic Dystrophy
N. D. Olson (1979)
10.1172/JCI109445
Pattern of insulin delivery after intravenous glucose injection in man and its relation to plasma glucose disappearance.
E. Ferrannini (1979)
10.1007/s11910-014-0457-5
Neurologic Complications of Diabetes
Gerald A Charnogursky (2014)
10.2337/diab.24.8.753
Serum Proinsulin in Children and Adolescents with Chemical Diabetes
A. Rosenbloom (1975)
10.1620/TJEM.137.437
Evaluation of new criteria for diagnosis of diabetes mellitus based on follow-up study of borderline diabetes.
A. Ohneda (1982)
10.1016/S0140-6736(77)91642-7
SEX HORMONES AND ATHEROSCLEROSIS
GeraldB. Phillips (1977)
10.1001/JAMA.1966.03110190061018
Early diabetes mellitus in perspective. A population study in Sudbury, Mass.
J. O'sullivan (1966)
10.1016/S0140-6736(60)91594-4
Detection of prediabetes by glucose-tolerance test sensitised by prednisolone.
Y. Goto (1960)
10.1007/BF02235244
Cirrhosis and diabetes
H. Conn (2005)
10.1016/S0140-6736(70)90706-3
Use of test strips with colour meter to measure blood-glucose.
E. Mazzaferri (1970)
10.1016/0026-0495(77)90126-3
Abnormal glucose tolerance in β-thalassemia major
Christopher D. Saudek (1977)
10.1007/BF01221979
Characterization of Chinese hamsters by metabolic balance, glucose tolerance and insulin secretion
G. Gerritsen (2005)
10.1111/j.1532-5415.1973.tb01648.x
Growth Hormone Levels in Chemical Diabetes
T. Stephan (1973)
10.1111/j.1749-6632.1968.tb27758.x
THE COURSE OF LATENT DIABETES *
D. Wilansky (1968)
10.2337/diab.24.9.820
Age-adjusted Analysis of Insulin Responses During Normal and Abnormal Glucose Tolerance Tests in Children and Adolescents
A. Rosenbloom (1975)
10.1001/ARCHINTE.1969.00300180021004
Serum glucose, insulin, and growth hormone in chronic hepatic cirrhosis.
N. Samaan (1969)
10.1007/978-3-642-66033-7_10
Die Wirkungen der Corticosteroide auf den Kohlenhydratstoffwechsel
H. Zimmermann (1975)
10.2337/diacare.4.1.137b
Selecting Criteria for the Diagnosis of “Diabetes Mellitus”
J. O'sullivan (1981)
La HbA1c en el diagnóstico y en el manejo de la diabetes
Germán Campuzano-Maya (2010)
Comparison of Glucose Tolerance of Children with or without Family History of Diabetes Mellitus Family
J. Court (2006)
10.2337/dc09-9033
International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes
D. Nathan (2009)
10.1001/ARCHINTE.1978.03630250060019
HLA in maturity-onset type of hyperglycemia in the young.
J. Barbosa (1978)
10.1016/0002-9378(66)90437-6
Glucose tolerance tests in pregnancy and clinical manifestations in the offspring.
M. S. Velasco (1966)
10.1007/BF01223157
Fasting and two-hour post-load glucose levels for the diagnosis of diabetes
N. Rushforth (2005)
10.2337/diacare.3.3.453
A Pilot Community-Based Screening Program for Gestational Diabetes
I. Merkatz (1980)
10.1016/S0140-6736(64)91745-3
INHERITANCE OF DIABETIC-SERUM FACTOR INHIBITING NORMAL UTILISATION OF INSULIN.
L. Stimmler (1964)
10.1161/01.STR.6.1.77
The Assessment of Insulin, Glucose and Lipids in Ischemic Thrombotic Cerebrovascular Disease
M. Gertler (1975)
10.1111/j.1532-5415.1973.tb01685.x
Age‐Related Changes in Growth Hormone in Non‐Diabetic Women
C. Vidalon (1973)
10.2337/diab.10.5.351
Calibration of a Simplified Cortisone Glucose Tolerance Test
C. Klimt (1961)
10.2337/diab.14.9.579
Reduced Glucose Tolerance in Elderly Human Subjects
D. Streeten (1965)
10.1007/BF00422812
The relationship between diagnostic information obtained from three tests for detecting mild diabetes mellitus
Klasse d (2004)
10.1136/bmj.288.6413.288
Prognostic importance of hyperglycaemia induced by stress after acute myocardial infarction.
A. Lakhdar (1984)
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