Fiche de révision : Understanding Diabetes: Types, Risks, and Management

📋 Course Outline

1. Diabetes Definition
2. Blood Glucose Levels
3. Type 1 and 2 Diabetes
4. Pre-Diabetes Criteria
5. Diabetes Complications
6. Insulin Physiology
7. Diabetes Management
8. Insulin Therapy
9. Glycemic Control Goals
10. Diabetes in Elderly

📖 1. Diabetes Definition

🔑 Key Concepts & Definitions

• Diabetes mellitus is characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both, leading to disturbances in carbohydrate, fat, and protein metabolism (Prise en charge du patient diabétique, 02/03/2026).
• Fasting blood glucose threshold for diabetes is ≥ 1.26 g/l (7 mmol/l), indicating impaired regulation of blood sugar levels (Prise en charge du patient diabétique, 02/03/2026).
• Oral Glucose Tolerance Test (OGTT) involves measuring blood glucose 2 hours after ingesting 75 g of glucose; a level ≥ 2 g/l (11.1 mmol/l) confirms diabetes (Prise en charge du patient diabétique, 02/03/2026).
• Hyperglycemia refers to elevated blood glucose levels beyond normal ranges, which has significant clinical implications including risk of microvascular and macrovascular complications (Prise en charge du patient diabétique, 02/03/2026).
• Pre-diabetes is distinguished from diabetes by glycemic values that are elevated but below diabetic thresholds, specifically fasting glucose between 1.10 and 1.25 g/l (6.1–6.9 mmol/l) or 2-hour OGTT between 1.40 and 1.99 g/l (7.8–11 mmol/l) (Prise en charge du patient diabétique, 02/03/2026).

📝 Essential Points

• The initial WHO definition of diabetes used a fasting blood glucose threshold of ≥ 1.10 g/l, later revised to ≥ 1.26 g/l to improve diagnostic accuracy (Prise en charge du patient diabétique, 02/03/2026).
• Glycemic thresholds serve to differentiate between normal, pre-diabetic, and diabetic states, with values above the diabetic thresholds indicating trouble regulation of blood glucose (Prise en charge du patient diabétique, 02/03/2026).
• Hyperglycemia's clinical significance lies in its role as a marker of disturbed glucose regulation and its association with increased risk of vascular damage and diabetic complications (Prise en charge du patient diabétique, 02/03/2026).

💡 Key Takeaway

Diabetes is diagnosed based on specific thresholds of fasting blood glucose and glucose tolerance test results, with hyperglycemia serving as a key indicator of abnormal glucose regulation and potential health risks. Pre-diabetes represents intermediate glycemic levels that signal increased risk for developing full-blown diabetes.

📖 2. Blood Glucose Levels

🔑 Key Concepts & Definitions

• Fasting blood glucose normal range: According to WHO and other guidelines, a fasting blood glucose level less than 1.10 g/l (6.1 mmol/l) is considered normal. Levels between 1.10 g/l and 1.25 g/l (6.1-6.9 mmol/l) indicate moderate hyperglycemia or prediabetes, while levels ≥1.26 g/l (7 mmol/l) on two separate occasions confirm diabetes (DR MURIEL COGNE, 2026).
• Abnormal fasting blood glucose: Fasting glucose ≥1.26 g/l (7 mmol/l) signifies diabetes, whereas 1.10-1.25 g/l (6.1-6.9 mmol/l) suggests prediabetes or moderate hyperglycemia, which increases risk for progression to diabetes (DR MURIEL COGNE, 2026).
• Postprandial blood glucose levels: Blood glucose measured 2 hours after a 75 g oral glucose load; levels ≥2 g/l (11.1 mmol/l) indicate diabetes, while levels between 1.40 g/l and 1.99 g/l (7.8-11 mmol/l) suggest impaired glucose tolerance (DR MURIEL COGNE, 2026).
• Diagnostic importance of postprandial levels: Elevated postprandial glucose is a key marker for diagnosing diabetes and assessing glycemic control, as it often rises earlier than fasting glucose in the progression of glucose regulation troubles (DR MURIEL COGNE, 2026).
• Use of capillary blood glucose devices: Capillary blood glucose testing via finger-prick is a practical method for daily monitoring, especially in outpatient settings, providing immediate results to guide management.
• Continuous glucose monitoring (CGM): Devices like Free Style Libre or Dexcom record interstitial glucose levels continuously, offering detailed glycemic profiles, detecting fluctuations, and aiding in therapy adjustments, particularly for insulin-treated patients (DR MURIEL COGNE, 2026).

📝 Essential Points

• Fasting blood glucose thresholds have evolved; initial WHO criteria used ≥1.10 g/l, later revised to ≥1.26 g/l for diabetes diagnosis, emphasizing the importance of accurate timing and repeated testing for confirmation (DR MURIEL COGNE, 2026).
• Postprandial glucose levels are critical in diagnosing diabetes and prediabetes, with 2-hour values ≥2 g/l (11.1 mmol/l) indicating diabetes (DR MURIEL COGNE, 2026).
• Capillary blood glucose testing is widely used for routine monitoring, but CGM devices provide a comprehensive picture of glycemic variability, especially useful in complex cases or insulin therapy management (DR MURIEL COGNE, 2026).
• HbA1c reflects average glycemia over approximately 3 months, with levels below 7% generally indicating good control; higher levels suggest poor management or increased risk of complications (DR MURIEL COGNE, 2026).
• The interpretation of HbA1c must consider factors like hemoglobinopathies, anemia, or conditions affecting red blood cell lifespan, which can distort results (DR MURIEL COGNE, 2026).

💡 Key Takeaway

Blood glucose levels, including fasting, postprandial, and HbA1c, are essential markers for diagnosing and monitoring diabetes, with each providing unique insights into glycemic control and risk stratification. Continuous glucose monitoring enhances understanding of glycemic variability, improving individualized management.

📖 3. Type 1 and 2 Diabetes

🔑 Key Concepts & Definitions

• Type 1 Diabetes: An autoimmune disease characterized by destruction of pancreatic beta cells leading to absolute insulin deficiency, typically presenting in childhood or young adulthood (AUTHOR (date)). It involves the presence of autoantibodies (Type 1).

• Type 2 Diabetes: A metabolic disorder primarily involving insulin resistance and a progressive decline in insulin secretion, often associated with obesity and metabolic syndrome (AUTHOR (date)). It usually develops in adults but increasingly affects younger populations.

• Autoimmune Nature of Type 1 Diabetes: The immune system mistakenly targets and destroys insulin-producing beta cells in the pancreas, leading to insulin deficiency (AUTHOR (date)). This process is marked by the presence of specific autoantibodies.

• Insulin Resistance: A condition where body tissues (muscle, fat, liver) respond inadequately to insulin, resulting in impaired glucose uptake and hyperglycemia, commonly seen in Type 2 diabetes and metabolic syndrome (AUTHOR (date)).

• MODY (Maturity Onset Diabetes of the Young): A rare monogenic form of diabetes caused by single gene mutations, presenting typically in adolescence or early adulthood, with autosomal dominant inheritance (AUTHOR (date)).

• Secondary Diabetes: Diabetes resulting from other medical conditions or treatments, such as pancreatic diseases (e.g., pancreatitis, surgery) or medications (e.g., corticosteroids), leading to impaired insulin production or action (AUTHOR (date)).

📝 Essential Points

• Differences in Pathophysiology: Type 1 diabetes involves autoimmune destruction of beta cells, leading to absolute insulin deficiency, whereas Type 2 diabetes is characterized by insulin resistance and a gradual decline in insulin secretion (AUTHOR (date)).

• Autoimmune markers are present in Type 1 but absent in Type 2, and the disease typically manifests in younger individuals with rapid onset. Conversely, Type 2 develops insidiously in adults, often associated with obesity and metabolic syndrome (AUTHOR (date)).

• Other forms of diabetes like MODY are monogenic and differ from the polygenic forms (Type 1 and Type 2), often presenting with specific clinical features and inheritance patterns. Secondary diabetes results from other diseases or treatments affecting pancreatic function or insulin action (AUTHOR (date)).

• Insulin resistance and metabolic syndrome are central to Type 2 diabetes, involving a cluster of risk factors including obesity, hypertension, dyslipidemia, and hyperglycemia, which predispose to cardiovascular complications (AUTHOR (date)).

💡 Key Takeaway

Type 1 diabetes is an autoimmune disease causing absolute insulin deficiency, typically in youth, while Type 2 diabetes involves insulin resistance and a progressive decline in insulin secretion, often linked to obesity and metabolic syndrome. Other forms like MODY and secondary diabetes have distinct etiologies and clinical features.

📖 4. Pre-Diabetes Criteria

🔑 Key Concepts & Definitions

• Impaired Fasting Glucose (IFG): A pre-diabetic state characterized by elevated fasting blood glucose levels that are higher than normal but below diabetic thresholds, typically defined by authorities as fasting glucose between 100-125 mg/dL (see criteria for pre-diabetes).
• Impaired Glucose Tolerance (IGT): A pre-diabetic condition identified by abnormal glucose levels during an oral glucose tolerance test (OGTT), with 2-hour plasma glucose values between 140-199 mg/dL (see criteria for pre-diabetes).
• Risk of Progression: According to AUTHOR (date), individuals with pre-diabetes (IFG or IGT) have a significant risk of developing Type 2 diabetes, especially if risk factors such as obesity or family history are present.
• Anthropometric Risk Factors: Factors like obesity, high BMI, and increased waist circumference that influence the transition from pre-diabetes to diabetes, as noted by AUTHOR (date).
• Familial Risk Factors: A family history of diabetes increases the likelihood of progression from pre-diabetes to Type 2 diabetes, emphasizing genetic predisposition as a key risk factor (see source content).

📝 Essential Points

• Pre-diabetes is diagnosed based on specific glycemic thresholds: fasting glucose between 100-125 mg/dL (impaired fasting glucose) and 2-hour post-OGTT glucose between 140-199 mg/dL (impaired glucose tolerance).
• Both IFG and IGT are significant predictors of future Type 2 diabetes, with the risk increasing if combined with anthropometric factors such as obesity or a positive family history.
• Screening for pre-diabetes should include measurement of fasting blood glucose and OGTT, especially in individuals with risk factors like obesity or familial predisposition.
• Management recommendations focus on lifestyle modifications, including weight loss and increased physical activity, to prevent or delay progression.

💡 Key Takeaway

Pre-diabetes, identified by impaired fasting glucose and impaired glucose tolerance, signals an elevated risk of developing Type 2 diabetes, with anthropometric and familial factors playing a crucial role in its progression. Early screening and lifestyle interventions are essential for prevention.

📖 5. Diabetes Complications

🔑 Key Concepts & Definitions

• Macrovascular complications: Vascular damages affecting large blood vessels, leading to cardiovascular diseases such as coronary artery disease, cerebrovascular disease, and peripheral arterial disease. These complications are primarily driven by chronic hyperglycemia and associated risk factors like hypertension and dyslipidemia (Geiss LS, 1995).

• Microvascular complications: Damage to small blood vessels caused by prolonged hyperglycemia, resulting in neuropathy, retinopathy, and nephropathy. These are directly related to the duration and control of hyperglycemia (Geiss LS, 1995).

• Neuropathy: A common complication characterized by nerve damage, leading to sensory loss, pain, and motor deficits, especially in the extremities. It significantly increases the risk of foot ulcers and amputations (Geiss LS, 1995).

• Retinopathy: Microvascular damage to the retinal vessels, which can cause visual impairment and blindness. It progresses from microaneurysms to proliferative retinopathy if untreated (Geiss LS, 1995).

• Nephropathy: Kidney damage resulting from microvascular injury, leading to proteinuria, decreased renal function, and potentially end-stage renal disease requiring dialysis or transplantation (Geiss LS, 1995).

• Impact of chronic hyperglycemia: Persistent high blood glucose levels cause cellular and vascular damage, accelerating organ dysfunction and increasing the risk of both macrovascular and microvascular complications, ultimately contributing to higher mortality (Geiss LS, 1995).

📝 Essential Points

• Chronic hyperglycemia is the primary driver of both macrovascular and microvascular complications, with the risk increasing with duration and poor glycemic control (Geiss LS, 1995).

• Macrovascular complications, such as coronary artery disease, are the leading causes of death in diabetic patients, accounting for 55-70% of mortality causes (Geiss LS, 1995).

• Microvascular complications, including neuropathy, retinopathy, and nephropathy, significantly impair quality of life and can lead to severe disabilities like blindness, amputations, and renal failure (Geiss LS, 1995).

• Foot ulcers and subsequent amputations are common due to combined neuropathy and peripheral arterial disease, emphasizing the importance of foot care and early detection (Geiss LS, 1995).

• Effective management of blood glucose, blood pressure, and lipid levels is crucial in preventing or delaying these complications (Geiss LS, 1995).

💡 Key Takeaway

Chronic hyperglycemia in diabetes leads to both macrovascular and microvascular organ damage, which are major contributors to morbidity and mortality; early detection and comprehensive management are essential to reduce these risks.

📖 6. Insulin Physiology

🔑 Key Concepts & Definitions

• Physiology of insulin secretion by the pancreas: The pancreas primarily produces insulin through specialized cells called beta cells located in the islets of Langerhans. Insulin secretion is a tightly regulated process that responds to blood glucose levels, with a rapid release following food intake (bolus secretion) and a continuous, low-level release during fasting (basal secretion) (source content).

• Role of insulin in glucose uptake and metabolism: Insulin facilitates the entry of glucose into insulin-sensitive tissues such as muscle and adipose tissue by promoting the translocation of GLUT4 transporters to the cell membrane. It also stimulates glycogen synthesis in the liver and muscle, lipogenesis in adipose tissue, and inhibits gluconeogenesis, thereby maintaining blood glucose homeostasis (source content).

• Concept of insulinopenia: Insulinopenia refers to a deficiency of insulin production by the pancreatic beta cells. It is responsible for the progressive development of hyperglycemia in diabetes, as the normal mechanisms for glucose regulation are impaired, leading to severe metabolic disturbances and potential life-threatening complications (source content).

• Basal and bolus insulin secretion patterns: Basal insulin secretion maintains blood glucose levels during fasting and between meals, providing a steady, low-level insulin supply. Bolus insulin secretion occurs rapidly after meals, in response to increased blood glucose, to facilitate glucose uptake and prevent postprandial hyperglycemia. These patterns mimic physiological insulin release (source content).

📝 Essential Points

• The pancreas's primary role is insulin production, which is vital for glucose regulation (source content). Insulin secretion is biphasic: an initial rapid release (bolus) followed by a sustained, lower-level release (basal) (source content).

• Insulin's main function is to promote glucose uptake into tissues such as muscle and adipose tissue, and to regulate hepatic glucose production through processes like glycogen synthesis and inhibition of gluconeogenesis (source content).

• A decrease in insulin secretion, termed insulinopenia, leads to inadequate glucose regulation, resulting in hyperglycemia and the development of diabetes mellitus (source content).

• The physiological secretion pattern of insulin involves basal secretion to maintain fasting glucose levels and bolus secretion to handle post-meal glucose surges, ensuring tight glycemic control (source content).

💡 Key Takeaway

Insulin secretion by the pancreas follows a biphasic pattern—basal and bolus—that is essential for maintaining blood glucose homeostasis; insulinopenia disrupts this balance, leading to hyperglycemia and diabetes complications.

📖 7. Diabetes Management

🔑 Key Concepts & Definitions

Lifestyle interventions for diabetes management: Non-pharmacological strategies including diet, physical activity, weight management, and behavioral modifications aimed at improving glycemic control and preventing complications (source content).

Monitoring glycemic control using blood glucose and HbA1c: The process of regularly measuring blood glucose levels through capillary blood tests or continuous glucose monitoring, and assessing long-term glycemic control via HbA1c, which reflects average blood glucose over approximately 3 months (source content).

Importance of individualized glycemic targets: Tailoring blood glucose and HbA1c goals based on patient-specific factors such as age, comorbidities, risk of hypoglycemia, and life expectancy to optimize safety and efficacy of management (source content).

Use of glucose monitoring devices in management: Devices like glucometers and continuous glucose monitors (CGMs) that enable real-time or periodic assessment of blood glucose levels, facilitating better control, patient engagement, and timely treatment adjustments (source content).

📝 Essential Points

• Lifestyle interventions are foundational in diabetes care, emphasizing dietary regulation, increased physical activity, and weight control to improve insulin sensitivity and reduce cardiovascular risk (source content).
• Blood glucose monitoring (capillary or interstitial) and HbA1c testing are critical for evaluating treatment effectiveness and guiding therapy adjustments (source content).
• Individualized glycemic targets are essential, especially in elderly or high-risk patients, to balance glycemic control with hypoglycemia risk (source content).
• Continuous glucose monitoring devices, such as the Free Style Libre or Dexcom, provide detailed glycemic profiles, improve patient self-management, and are particularly useful for insulin-treated patients (source content).
• Regular monitoring and personalized targets contribute to early detection of hyperglycemia or hypoglycemia, preventing long-term complications and improving quality of life (source content).

💡 Key Takeaway

Effective diabetes management relies on tailored lifestyle modifications and the strategic use of blood glucose monitoring devices, with glycemic targets individualized to each patient's clinical context to optimize outcomes and safety.

📖 8. Insulin Therapy

🔑 Key Concepts & Definitions

• Indications for insulin therapy: Initiation of insulin is recommended in patients with Type 1 diabetes, those with severe hyperglycemia (e.g., fasting glucose ≥ 1.26 g/l or 7 mmol/l), or when oral hypoglycemic agents fail to achieve glycemic control, especially in cases of significant insulin deficiency or during pregnancy (see source content on diabetes management).

• Types of insulin preparations:

  • Basal insulin: Long-acting insulins designed to provide a steady level of insulin throughout the day and night, mimicking physiological basal secretion (e.g., glargine, detemir).
  • Bolus insulin: Rapid-acting insulins administered at mealtimes to control postprandial glucose spikes (e.g., lispro, aspart, glulisine).

• Adjustment of insulin doses based on blood glucose levels: Insulin doses are titrated according to blood glucose measurements, with basal insulin adjusted for fasting glucose levels and bolus insulin modified based on postprandial readings, aiming for individualized glycemic targets (see source content on glycemic control).

• Use of insulin pumps and continuous glucose monitoring (CGM):

  • Insulin pumps: Devices delivering continuous subcutaneous insulin infusion, allowing precise and adjustable basal and bolus doses, improving glycemic control.
  • Continuous glucose monitoring: Devices that measure interstitial glucose levels in real-time, providing detailed glucose profiles to optimize insulin therapy and reduce hypoglycemia risk (see source content on insulin management and glucose monitoring).

📝 Essential Points

• Insulin therapy is essential in Type 1 diabetes and often indicated in advanced Type 2 diabetes when oral agents are insufficient or contraindicated.
• Basal and bolus insulins are used in combination to replicate physiological insulin secretion, with adjustments based on blood glucose levels to prevent hypo- and hyperglycemia.
• Insulin pumps and CGM systems have revolutionized diabetes management by providing real-time data, enabling dynamic dose adjustments, and reducing glycemic variability.
• Proper titration of insulin doses requires regular monitoring of blood glucose, considering factors such as meal intake, physical activity, and stress.
• The choice of insulin type and delivery method should be individualized, considering patient lifestyle, age, comorbidities, and risk of hypoglycemia.

💡 Key Takeaway

Effective insulin therapy involves selecting appropriate insulin preparations, tailoring doses based on blood glucose monitoring, and utilizing advanced delivery systems like pumps and CGM to optimize glycemic control and minimize complications.

📖 9. Glycemic Control Goals

🔑 Key Concepts & Definitions

• Glycemic targets for different populations: Specific blood glucose level goals tailored to patient groups such as young, pregnant, or elderly individuals, considering their physiological and health status (see section on elderly and pregnancy considerations).
• Goals for fasting and postprandial glucose levels: Optimal blood glucose ranges aimed at minimizing complications; typically, fasting glucose targets are between 0.80-1.10 g/l, and postprandial targets are between 0.90-1.40 g/l for young patients, with variations for pregnant and elderly populations (see source content).
• Adjusting targets based on patient profile and comorbidities: Modifying glycemic goals according to individual factors such as age, presence of complications, cognitive status, and overall health to balance benefits and risks, especially hypoglycemia (see section on elderly and individualized management).
• Timing of glucose measurements: The importance of varying measurement times—fasting, pre-prandial, and post-prandial—to accurately assess glycemic control and guide therapy adjustments (see source content on glucose monitoring).

📝 Essential Points

• Glycemic targets differ significantly among populations: young, pregnant, and elderly patients require tailored goals to optimize outcomes and reduce risks. For example, pregnant women aim for stricter control (e.g., fasting <0.95 g/l), while elderly patients may have more relaxed targets (e.g., HbA1c ≤8-9%) to prevent hypoglycemia and account for comorbidities.
• The timing of glucose measurements is critical; fasting, pre-prandial, and postprandial levels provide comprehensive insights into glycemic control, enabling precise therapy adjustments. Varying measurement times helps detect fluctuations and prevent complications.
• Targets for fasting glucose generally aim to be below 1.10 g/l, while postprandial goals are often set below 1.40 g/l, but these can be adjusted based on patient-specific factors such as age, pregnancy status, and comorbidities.
• Individualization of glycemic goals is essential, especially in elderly or complex patients, to prevent hypoglycemia and other adverse effects, emphasizing the importance of a patient-centered approach.

💡 Key Takeaway

Glycemic control goals must be personalized according to patient age, health status, and comorbidities, with careful timing of glucose measurements to optimize management and minimize risks.

📖 10. Diabetes in Elderly

🔑 Key Concepts & Definitions

• Epidemiology of diabetes in elderly populations: The study of the distribution and determinants of diabetes among older adults, highlighting increased prevalence with age. In France, the average age of diagnosed diabetics is around 65.1 years (Ricci et al., 2010), with a significant rise in cases among those aged 65 and above, especially in regions like Réunion where prevalence reaches 8.8% (source data).

• Impact of aging on diabetes prevalence and management: Aging influences the rising prevalence of diabetes, with older adults often presenting multiple comorbidities and altered physiological responses. The prevalence of diabetes in those over 75 years is notably higher, with estimates showing 36% having chronic kidney disease (Pornet et al., 2011). Management strategies must adapt to age-related changes, including reduced renal function and cognitive decline.

• Concepts of successful, usual, and pathological aging:

  • Successful aging: characterized by absence of disease, high physical and cognitive function, and active engagement (Darcourt, 2000).
  • Usual aging: includes age-related functional decline without significant disease.
  • Pathological aging: marked by early onset of diseases, disabilities, and increased risk of complications, often seen in elderly diabetics with multiple comorbidities (Darcourt, 2000).

• Comorbidities and polypharmacy considerations in elderly diabetic patients: Older diabetics frequently have multiple health conditions such as hypertension, cardiovascular disease, and renal impairment, leading to polypharmacy. The presence of comorbidities complicates glycemic control and increases risk of adverse drug interactions, hypoglycemia, and other complications (Harboun, 2007; ALFEDIAM, 2008).

📝 Essential Points

• The prevalence of diabetes increases significantly with age, with over 35% of those aged 65+ affected in regions like Réunion, where the average age of diabetic patients is lower than the national average (Ricci et al., 2010).
• Aging impacts diabetes management due to physiological changes such as decreased renal function, altered drug metabolism, and cognitive decline, necessitating personalized treatment plans (Sinclair et al., 2011).
• Elderly diabetics often experience multiple comorbidities, which heighten the risk of complications like hypoglycemia, cardiovascular events, and renal failure. Polypharmacy increases the risk of adverse effects and drug interactions, requiring careful medication review (Harboun, 2007; ALFEDIAM, 2008).
• The concept of frailty, as defined by Fried et al. (2001), helps identify vulnerable elderly patients who are at higher risk of adverse outcomes, including hypoglycemia and functional decline.
• The prognosis of diabetes in the elderly is closely linked to the degree of aging-related functional decline, with a distinction between successful, usual, and pathological aging guiding management strategies.

💡 Key Takeaway

Aging significantly influences the prevalence, management, and outcomes of diabetes in elderly populations, requiring a personalized, holistic approach that considers comorbidities, polypharmacy, and the patient's overall aging process.

📅 Key Dates

(OMIT: No significant dates provided)

📊 Synthesis Tables

⚠️ Common Pitfalls & Confusions

• Confusing insulin deficiency in Type 1 with insulin resistance in Type 2.
• Overlooking autoimmune markers in diagnosing Type 1.
• Assuming all hyperglycemia in young patients is Type 2.
• Misclassifying MODY as Type 1 or 2.
• Ignoring secondary causes like pancreatic diseases.
• Confusing autoantibodies presence with disease severity.
• Overgeneralizing the age of onset for either type.

✅ Exam Checklist

• Know the WHO and ADA blood glucose thresholds for diagnosing diabetes, including fasting glucose ≥1.26 g/l and 2-hour OGTT ≥2 g/l.
• Understand the significance of hyperglycemia and its link to microvascular and macrovascular complications.
• Master the definitions and differences between prediabetes and diabetes, including glycemic ranges.
• Be familiar with blood glucose monitoring methods: capillary testing, continuous glucose monitoring, and HbA1c interpretation.
• Know the pathophysiology of Type 1 diabetes as autoimmune destruction of beta cells and the presence of autoantibodies.
• Understand the pathophysiology of Type 2 diabetes involving insulin resistance and beta-cell decline.
• Recognize the clinical features and typical age of onset for Type 1 and Type 2 diabetes.
• Know the key authors and their concepts, such as the WHO's thresholds and the role of autoantibodies in Type 1.
• Be aware of secondary causes of diabetes, including pancreatic diseases and medications.
• Understand the management goals for glycemic control, including target HbA1c levels.
• Review the complications of diabetes, both microvascular and macrovascular.
• Know the importance of early diagnosis and tailored treatment strategies for different types of diabetes.