Laboratory diagnosis and the use of Glucometers in the Management of Diabetes Mellitus

Abstract

Diabetes Mellitus (DM) is a global concern. Nigeria has not been spared the burden of this disease. Diabetes accounts for a significant number of hospital admissions and deaths in Nigeria.

Diagnosis of DM is confirmed by laboratory or biochemical investigation. A provisional diagnosis is made first in cases with clear clinical features, such as hyperglycaemic crises or overt complications and substantiated by a biochemical diagnosis. Diagnosis using any of the diagnostic tools is usually by two different tests done on the same specimen or two abnormal results from two different specimens from the same patient. Effective management of diabetes mellitus is multidisciplinary. The chemical pathologists and clinicians must work hand in glove.

Screening is done for adults above 45 and for at-risk individuals. The American Diabetes Association (ADA) recommends screening all asymptomatic adults for DM starting from 45 years and three yearly thereafter. Obese and overweight adolescents and adults below 45 years and any overweight person with an extra risk regardless of age should also be screened at any opportunity. Extra risk factors include hypertension, increased cholesterol, heart disease, etc. Children who are obese (body mass index at the 95th percentile) and have at least one additional risk factor should be screened at 10 years of age or at the onset of puberty, whichever comes first. 3 Risk factors for children include maternal history of GDM or DM and race (Blacks, American Indian, Hispanic). Screening should be repeated every 3 years.