diabetes Hyperglycemia

[63SIERRA]

ok, just found active problem list in med recs. it saysd hyperglycemia.

I did a little research and it appears liver disease can cause hyperglycemia because the liver helps regulate carbs and sugar. I have resids of hepc. So my question is, is this part of the resides of hep c that im getting 40 percent for, or should I file seperate claim for hyperglycemia,. which leads to diabetes.

[JT24usn]

It is my understanding Hyperglycemia is a lab finding. It must manifest into something. I have been fighting hypoglycemia. They say it is a lab finding. Kind of like low vitamin d. I am deficient however ( and luckily) it hadn't caused any problems yet... So it isn't service connectable. Jmho

[63SIERRA]

I recall he PA saying it may be pre diabetes.

[BakerGeckos]

I am fighting the same stuff Just got Denied Diabetes due to Hepatic Stetosis or Hepatic Stereoheptitis and now getting a IMO for it. But I believe he is right it needs to progress to a Diagnosis of Diabetes.

[63SIERRA]

What entails the diagnosis of diabetes is the question. must you be 800 lbs and legally blind before the say your diabetic. ?

[JT24usn]

No, lab findings. Weight has nothing to do with it. Lab findings, such as hyperglycemia can be a precursor to diabetes but still just a lab finding.

Merck Manual

http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/diabetes_mellitus_and_disorders_of_carbohydrate_metabolism/diabetes_mellitus_dm.html#v988183

Diagnosis

Fasting plasma glucose (FPG) levels

Glycosylated Hb (HbA1c)

Sometimes oral glucose tolerance testing

DM is indicated by typical symptoms and signs and confirmed by measurement of plasma glucose. Measurement after an 8- to 12-h fast (FPG) or 2 h after ingestion of a concentrated glucose solution (oral glucose tolerance testing [OGTT]) is best (see see Diagnostic Criteria for Diabetes Mellitus and Impaired Glucose Regulation). OGTT is more sensitive for diagnosing DM and impaired glucose tolerance but is less convenient and reproducible than FPG. It is therefore rarely used routinely, except for diagnosing gestational DM (see Diabetes Mellitus in Pregnancy (Gestational Diabetes)) and for research purposes.

In practice, DM or impaired fasting glucose regulation is often diagnosed using random measures of plasma glucose or of HbA1c. A random glucose value > 200 mg/dL (> 11.1 mmol/L) may be diagnostic, but values can be affected by recent meals and must be confirmed by repeat testing; testing twice may not be necessary in the presence of diabetic symptoms. HbA1c measurements reflect glucose levels over the preceding 3 mo. HbA1c measurements are now included in the diagnostic criteria for DM:

HbA1c≥ 6.5% = DM

HbA1c 5.7 to 6.4% = prediabetes or at risk of DM

However, HbA1c values may be falsely high or low (see Monitoring), and tests must be done in a certified clinical laboratory with an assay that is certified and standardized to a reference assay. Point-of-care HbA1c measurements should not be used for diagnostic purposes, although they can be used for monitoring DM control.

Urine glucose measurement, once commonly used, is no longer used for diagnosis or monitoring because it is neither sensitive nor specific.

Pearls & Pitfalls

Point-of-care HbA1c tests are not accurate enough to be used for initial diagnosis of diabetes.

Screening for disease: Screening for DM should be conducted for people at risk of the disease. Patients with DM are screened for complications.

People at high risk of type 1 DM (eg, siblings and children of people with type 1 DM) can be tested for the presence of islet cell or anti-glutamic acid decarboxylase antibodies, which precede onset of clinical disease. However, there are no proven preventive strategies for people at high risk, so such screening is usually reserved for research settings.

Risk factors for type 2 DM include age > 45; overweight or obesity; sedentary lifestyle; family history of DM; history of impaired glucose regulation; gestational DM or delivery of a baby > 4.1 kg; history of hypertension or dyslipidemia; polycystic ovary syndrome; and black, Hispanic, or American Indian ethnicity.

Risk of insulin resistance among overweight people (body mass index ≥ 25 kg/m2) is increased with serum triglycerides ≥ 130 mg/dL (≥ 1.47 mmol/L); triglyceride/high-density lipoprotein (HDL) ratio ≥ 3.0 (≥ 1.8); and insulin≥ 108 pmol/L. People > age 45 and all adults with additional risk factors described above should be screened for DM with an FPG level, HbA1c, or a 2-h value on a 75-g OGTT at least once every 3 yr as long as plasma glucose measurements are normal and at least annually if results reveal impaired fasting glucose levels (see see Diagnostic Criteria for Diabetes Mellitus and Impaired Glucose Regulation).

Edited December 11, 2013 by T8r

[meghp0405]

63Sierra,

T8R is correct, it is a lab finding....