[Pitfalls in the diagnosis and treatment optimization of type 2 diabetes].
The diagnosis of diabetes mellitus would appear a simple matter. However, potential pitfalls in clinical practice need to be avoided, and this requires knowledge and attention. An initially pathological oral glucose tolerance test should be repeated before establishing a final diagnosis, since such necessary preconditions as a 10 to 16 hours fast, or alcohol abstinence, are difficult to monitor in the clinical setting. Accurate glucose testing requires appropriate sample preparation and handling. Further pitfalls may be encountered during treatment: HbA1c assessment is associated with certain limitations and does not permit the estimation of glucose variations. To establish a differential diagnoses between type 1 (LADA) and type 2 diabetes in older patients GAD must be measured. New biochemical markers such as adiponectin and intact proinsulin may facilitate treatment decisions and monitoring in patients with type 2 diabetes.
Pfützner
A
A
Institut für klinische Forschung und Entwicklung Mainz. andreasp@ikfe.de
Kerner
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W
D052242:Adiponectin; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood; D011384:Proinsulin / Q000097:blood; D013997:Time Factors
D052242:Adiponectin; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D036341:Intercellular Signaling Peptides and Proteins; D011384:Proinsulin