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What is diabetes?

Diabetes is defined by an increase in blood sugar (glucose it is). The American Association of Diabetes (ADA) proposed in 1995 a modified biological criteria of diabetes, due to international epidemiological data showing that the diagnosis of diabetes was delayed. To facilitate the implementation of screening across field practitioners, it has simplified the diagnostic criteria: the glycemic threshold at which we speak of diabetes was 1.40 g / l is now 1.26 g / l. WHO in 1998, then France through the National Agency for Accreditation and Evaluation in Health (ANAES) in 1999, have also adopted these values in order to allow management of diabetes earlier and expand its domain to a larger number of subjects at risk.

You will find below the diagnostic criteria of diabetes mellitus:
1 – Symptoms of diabetes (polyuria, unexplained weight loss) and blood glucose regardless of the time of harvesting, including postprandial than 2 g / l.
2 – Fasting blood glucose greater than 1.26 g / l, this figure should be checked twice.
3 – Blood glucose greater than 2 g / l after ingestion of 75 g glucose orally. However, this test Oral glucose tolerance, which is not the purpose of clear recommendations currently has no place in current medical practice.

There are two types of diabetes: Type I diabetes requires daily treatment with insulin, diabetes type II most often associated with being overweight, can be treated with diet and / or drugs. Diabetes type II diabetes for nine out of ten about.

Screening: for whom?

The major studies on diabetes screening are mainly North American and show that, in the U.S., despite a prevalence of diabetes than that observed in France (6% 3% cons), it does not seem appropriate to propose a screening systematic type 2 diabetes in the general population.
The ADA provides, however, a diabetes screening targeted at-risk individuals such as the aisles of the first degree of diabetes, obesity, high blood pressure, dyslipidemia, renal impairment, women with a history of gestational diabetes. Screening by FPG should be performed every 3 years. These recommendations are very similar proposals screening published in 1998 by the High Committee on Public Health.
ANAES made recommendations for diabetes screening in February 2003. The conclusions of the experts recommend opportunistic screening targeted to the elderly over age 45 with at least one risk factor for diabetes among subjects over 45 years in a precarious situation, with or without other risk factor, all 3 years. This screening should be performed by a test of fasting glucose produced in the laboratory.