PEBC MCQ Diabetes, Thyroid, Bone & Hormones question: routine bloodwork showing a fasting plasma glucose

PEBC MCQDiabetes, Thyroid, Bone & Hormones

RW, 48, had routine bloodwork showing a fasting plasma glucose of 7.4 mmol/L. He has no symptoms of hyperglycemia. Repeat testing on another day shows an A1C of 6.6%. How should these results be interpreted?

a. Prediabetes, since he has no symptoms of high blood sugar
b. Type 2 diabetes is confirmed by two abnormal tests
c. Not yet diagnosed; a 75 g glucose tolerance test is required
d. Normal glucose tolerance; repeat testing in 3 years

Show the answer and explanation

Answer: b. Type 2 diabetes is confirmed by two abnormal tests

Diabetes Canada diagnostic thresholds are fasting plasma glucose 7.0 mmol/L or higher, A1C 6.5% or higher, 2-hour plasma glucose 11.1 mmol/L or higher on a 75 g OGTT, or a random value of 11.1 or higher with symptoms. Without symptoms, a second abnormal test (same or different test, on another day) confirms the diagnosis. RW's FPG of 7.4 and A1C of 6.6% both meet criteria. Source: Diabetes Canada CPG, ch. 4 Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome (Can J Diabetes 2018;42:S10).

Common mistake

Requiring symptoms or an OGTT when two abnormal tests already confirm diabetes.

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