Laboratory tests are performed on a postmenopausal, 57-year-old female as part of an annual physical examination. The patient's casual plasma glucose is 220 mg/dL, and the glycated hemoglobin (Hb A1C) is 11%. Based on this information, how should the patient be classified?

Laboratory tests are performed on a postmenopausal, 57-year-old female as part of an annual physical examination. The patient's casual plasma glucose is 220 mg/dL, and the glycated hemoglobin (Hb A1C) is 11%. Based on this information, how should the patient be classified?

• A. Normal glucose tolerance
• B. Impaired glucose tolerance
• C. Gestational diabetes mellitus
• D. Type 2 diabetes mellitus

Answer: (D)

Chronic hyperglycemia is diagnosed when glycemic measurements cross established thresholds. An HbA1c of 11% shows long-term elevated blood glucose well above the diabetes cutoff of 6.5%, confirming diabetes. The casual (random) plasma glucose of 220 mg/dL also fits the diabetes range (a value ≥200 mg/dL in the setting of hyperglycemia). Gestational diabetes is limited to pregnancy, so it doesn’t apply to a 57-year-old. Impaired glucose tolerance refers to a 2-hour glucose in the 140–199 mg/dL range after an oral glucose tolerance test, which is not what’s shown here. Therefore, this pattern is best classified as type 2 diabetes mellitus, consistent with chronic hyperglycemia typical in older adults.

Chronic hyperglycemia is diagnosed when glycemic measurements cross established thresholds. An HbA1c of 11% shows long-term elevated blood glucose well above the diabetes cutoff of 6.5%, confirming diabetes. The casual (random) plasma glucose of 220 mg/dL also fits the diabetes range (a value ≥200 mg/dL in the setting of hyperglycemia). Gestational diabetes is limited to pregnancy, so it doesn’t apply to a 57-year-old. Impaired glucose tolerance refers to a 2-hour glucose in the 140–199 mg/dL range after an oral glucose tolerance test, which is not what’s shown here. Therefore, this pattern is best classified as type 2 diabetes mellitus, consistent with chronic hyperglycemia typical in older adults.