Diagnosis of Dysglycemia in Diabetic Patients in Primary Health Care
Mohammed Ibrahim Habadi *
Department of Family and Community Medicine, University of Jeddah, Jeddah, Saudi Arabia.
Muslima Muaidh Alrashidi
General Practitioner, King Khalid Hospital, Hail, Saudi Arabia.
Ibrahiem Fahad Mutaki
Department of Emergency Medicine, King Fahad Hospital, AlAhsa, Saudi Arabia.
Khaznah Awad Alshammari
General Practitioner, Maternity and Children Hospital, Hail, Saudi Arabia.
Jawaher Hussain Alothayqi
College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia.
Abdassalam Fhid Alenezi
College of Medicine, University of Hail, Saudi Arabia.
Saeed Ahmad Hethwell
College of Medicine, King Khalid University, Abha, Saudi Arabia.
Yasser Meshal Alruwaily
College of Medicine, Northern Border University, Arar, Saudi Arabia.
Yasir Awadh Allah Aloufi
Taif Primary Health Care, Ministry of Health, Taif, Saudi Arabia.
Turki Ramadan Almulla
College of Medicine, Northern Border University, Arar, Saudi Arabia.
Malak Abduallah Al-Bogami
College of Medicine, Princess Nourah bint Abdul Rahman University, Riyadh, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
An early diagnosis of diabetes is a cornerstone for achieving the best prognostic outcomes. The potential complications take time to develop. For this reason, diabetic patients, especially type 2 are usually diagnosed with the disease after complications have been arisen. Dysglycemia is a term that has been used to describe the fluctuations in the plasma glucose levels, including the high (hyperglycemia) and low (hypoglycemia) levels, and can also refer to impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Many modalities have been developed to assess plasma glucose levels. Studies have shown that advantages and disadvantages are reported for each modality when assessing dysglycemia and screening for diabetes. The aim of this review is to discuss the previously reported diagnostic approaches of dysglycemia among diabetic patients according to the existing published studies in the literature. The study is related to the following: the 50-g oral glucose challenge test, HbA1c, fasting blood glucose, random blood sugar, and oral glucose tolerance tests in the assessment of the blood glucose fluctuating levels. Based on the findings, it is recommended that HbA1c levels assessment should be simultaneously conducted with the random and fasting blood glucose tests to decide which patients are required to perform an OGTT. Moreover, HbA1c tests might not be affordable in some healthcare settings although they are important indicators of long-term glycemic control.
Keywords: Dysglycemia, diabetes, HbA1c, blood glucose, primary healthcare, Mohammed Ibrahim Habadi