Resumen

GONZALEZ SUAREZ, Roberto M.; ARRANZ CALZADO, María Celeste  y  PERICH AMADOR, Pedro. Critical evaluation of the diagnostic system of diabetes mellitus proposed by the American Diabetes Association. Rev Cubana Endocrinol [online]. 2002, vol.13, n.2. ISSN 1561-2953.

A retrospective study was carried out in 370 subjects with glucose tolerance disorders aimed at evaluating the methodology for diagnosing type 2 diabetes mellitus that leaves out the oral glucose tolerance test (GTT) proposed by the ADA, It was found that fasting glycaemia allowed to diagnose 27 % of the diabetics and 56 % of the individuals with glycaemia regulation disorders that would have been diagnosed according to the WHO criteria that include the GTT. The third part of those cases classified as normal based only in glycaemia during fasting presented some type of glucose tolerance disorder. It was proved that the diabetics detected by hyperglycemia at the second hour had higher levels of circulating glucose during the test evaluated by the total area under the glucose curve. The pattern of insulinic response of these cases was characterized by a diminished initial response that increased up to reaching maximum values at the second hour. The frequency of cases with low insulinic response and/or insulin resistance was high. It was concluded that the fasting glycaemia test by itself was not sensitive enough to detect glucose tolerance disorders, diabetes mellitus and those cases with postprandial hyperglycaemia, and that’s why they can only be detected by GTT. As these patients present important metabolic disorders that require an early detection and treatment, it is recommended the systematic use of GTT in the diagnosis of diabetes mellitus.

Palabras clave : DIABETES MELLITUS; HYPERGLYCEMIA; ENDOCRINE DIAGNOSIS TECHNIQUE; GLUCOSE INTOLERANCE.