The American Diabetes Association (ADA) approved new diagnostic criteria for diabetes mellitus in 1997. Altering the diagnostic criteria may result in variable effects on the prevalence of diabetes. In this study, we aimed to evaluate the difference between World Health Organisation (WHO) and ADA criteria in practice and the impact of new criteria on the frequency of diabetes mellitus and prediabetic conditions in patients who need to have their glucose metabolism evaluated. <br> Two hundred and fifty patients (182 females and 68 males, age 53.1 ± 11.6 years) who were not known to be diabetic were studied. Subjects with a fasting plasma glucose level of 110 mg/dl and above, or with a fasting plasma glucose of 100-109 mg/dl and a risk factor were included in the study. An oral glucose tolerance test with 75 g glucose was performed on all patients. The diagnoses of diabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) as defined by two different sets of criteria were compared. <br> When patients were evaluated according to WHO criteria, 115 patients (46.0 %) had normal glucose tolerance, 76 (30.4 %) had IGT and 59 (23.6 %) were diabetic. When patients were evaluated according to ADA criteria, only 19 patients (7.6 %) had normal glucose tolerance, 52 (20.8 %) had IGT, 113 (45.2 %) had diabetes mellitus (DM) and 66 (26.4 %) patients had IFG. There is an important difference in the diagnosis of patients (κ=0.45). The most striking difference is in the group that has fasting plasma glucose between 110-125 mg/dl, especially because of the definition of IFG in the new criteria. <br> In conclusion, use of the ADA criteria caused an evident change in the frequency of diabetes mellitus and prediabetic conditions in the study population. These results suggest that the new criteria are more sensitive and useful in diagnosing diabetes and especially prediabetic conditions, and also can be applied more easily. This study only considers patients who needed the evaluation of glucose metabolism. Further studies are needed to evaluate the change in frequency in similar populations.

Keywords:
Diagnostic criteria, Diabetes Mellitus
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2002
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