In NPCDCS criteria for diagnosis of Type-2 Diabetes Mellitus using venous blood is?

Maharashtra CHO - 2020

Medical & Surgical Nursing

Easy

Appeared in: Maharashtra CHO - 2020

Explanation

The correct diagnostic criteria for Type 2 Diabetes Mellitus are a Fasting Plasma Glucose (FPG) of 126 mg/dL or more, or a 2-hour post-load glucose value of 200 mg/dL or more.
These criteria are established by the World Health Organization (WHO) and are adopted by national health programs in India, such as the NPCDCS.
A diagnosis based on these values should be confirmed by a repeat test on a different day, unless the patient presents with clear symptoms of hyperglycemia (like polyuria, polydipsia) and a random plasma glucose of 200 mg/dL or more.
Another diagnostic criterion is an HbA1c value of 6.5% or greater, which reflects average blood glucose over the past 2-3 months.

Option A: These values (Fasting greater than 110 mg/dL or post-glucose greater than 140 mg/dL) define prediabetes, specifically Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT), not overt diabetes.
Option C: This range (Fasting Glucose 100 to 125 mg/dL) specifically defines Impaired Fasting Glucose (IFG), a category of prediabetes.
Option D: This range (140 to less than 200 mg/dL) defines Impaired Glucose Tolerance (IGT) based on a 2-hour post-glucose test, not a fasting glucose level as the option states.

Clinical Relevance

Nursing practice connection: Use the key finding related to Diagnostic criteria for Type 2 Diabetes Mellitus under NPCDCS guidelines to guide bedside assessment, documentation, and the next nursing action.
Accurate diagnosis based on these criteria is crucial for initiating timely management, including lifestyle modification and pharmacotherapy, to prevent long-term complications like retinopathy, nephropathy, and neuropathy.
Nurses play a key role in screening, patient education for sample collection (e.g., ensuring an 8-hour fast), and interpreting results for referral under the NPCDCS program.
What if? If a patient's fasting glucose is 120 mg/dL, they are not diagnosed with diabetes but with prediabetes (Impaired Fasting Glucose). The nursing action would be to provide intensive lifestyle counseling rather than initiating medication.

How to Approach the Question

Step 1: Identify the core of the question, which asks for the specific diagnostic criteria for Type 2 Diabetes under the NPCDCS program.
Step 2: Recall the standard blood glucose thresholds for diagnosing diabetes. These are internationally recognized values.
Step 3: Evaluate each option against these standard criteria. A fasting glucose of 126 mg/dL or more, or a 2-hour post-glucose level of 200 mg/dL or more, is diagnostic.
Step 4: Analyze the incorrect options. Options A and C describe the ranges for prediabetes (Impaired Fasting Glucose/Impaired Glucose Tolerance). Option D incorrectly labels a post-glucose range as a fasting range.
Step 5: Select the option that matches the established diagnostic thresholds for diabetes mellitus.

Concept Tested & Keywords

Concept Tested: Diagnostic criteria for Type 2 Diabetes Mellitus under NPCDCS guidelines.
Stem keywords: NPCDCS, diagnosis, Type-2 Diabetes Mellitus, venous blood
Lead-in keywords: criteria for diagnosis
Clinical cues: NPCDCS guidelines specify the exact blood glucose thresholds for diagnosis.

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