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Second Step

1. Repeat FBG only if the first fasting blood glucose is over 7.0 and HbA1c<6.5%

Results:

Diabetes confirmed: if repeat FBS is ≥ 7.0 mmol/L

Impaired Fasting Glucose: if repeat FBS estimation < 7 mmol/L

2. Oral Glucose Tolerance Test (OGTT) if the first FBG is 6.1-6.9 mmol/L and HbA1c ≥ 6.5%

(Consider OGTT in circumstances when HbA1c may be unreliable)

Oral Glucose Tolerance Test

OGTT can be reserved for those with IFG (FBG 6.1-6.9 mmol/L) and HbA1c >6.5% in whom reclassification is judged appropriate.

If reclassification (by OGTT) is not undertaken such patients can remain categorised as IFG and followed up accordingly with annual retesting.

Oral glucose tolerance testing should only be undertaken after 5 days of unrestricted foot and carbohydrate intake.

OGTT

 

2hour BG

Diabetes

≥ 11.1

IGT (Impaired Glucose tolerance)

7.8-11.1

Normal

<7.8

Where reclassification by OGTT is considered appropriate the outcomes can only be:

  • Diabetes

  • Impaired Glucose Tolerance

  • Impaired Fasting Glucose (patients with IFG who have a normal 2h BG are still IFG).