Diagnosis of Dysglycemia in Diabetic Patients in Primary Health Care

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.