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It covers prediabetes definitions, metabolic targets for HbA1c and capillary plasma glucose, monitoring frequency for glycemic control and complications, and referral pathways across endocrinology, ophthalmology, nephrology, and cardiology. It also specifies diabetes screening strategies in apparently healthy adults, ill patients, and pregnancy, plus relevant abbreviations and advisory guidance.",{"@graph":63,"@context":112},[64,80,95],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":46,"@type":70,"position":76},"https://docshare.wps.com/template/paper-templates/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/diabetes-mellitus-type-2-standard-treatment-workflow-stw/563783/",4,{"url":78,"name":59,"@type":81,"author":82,"headline":59,"publisher":85,"fileFormat":88,"inLanguage":57,"description":61,"dateModified":89,"datePublished":89,"encodingFormat":88,"isAccessibleForFree":90,"interactionStatistic":91},"DigitalDocument",{"name":83,"@type":84},"Connor ","Person",{"url":68,"name":86,"@type":87},"DocShare","Organization","application/pdf","2026-10-12",true,{"@type":92,"interactionType":93,"userInteractionCount":4},"InteractionCounter",{"@type":94},"ViewAction",{"@type":96,"mainEntity":97},"FAQPage",[98,104,108],{"name":99,"@type":100,"acceptedAnswer":101},"What are the diagnostic criteria for Diabetes Mellitus Type 2?","Question",{"text":102,"@type":103},"Diabetes is diagnosed using criteria such as random plasma glucose ≥ 200 mg/dl with symptoms, FPG ≥ 126 mg/dl after 8 hours fasting, or HbA1c ≥ 6.5%.","Answer",{"name":105,"@type":100,"acceptedAnswer":106},"What metabolic targets should be followed for treatment?",{"text":107,"@type":103},"The workflow targets HbA1c ≤ 7.0% (with exceptions for elderly and significant comorbidities), pre-prandial capillary glucose 80–130 mg/dl, post-prandial glucose \u003C 180 mg/dl, and BP and LDL targets (with lower LDL for CAD).",{"name":109,"@type":100,"acceptedAnswer":110},"How should screening for diabetes be done in different populations?",{"text":111,"@type":103},"Screen apparently normal adults with obesity/overweight plus risk factors, screen ill adults presenting suggestive complaints (e.g., osmotic symptoms, recurrent infections, non-healing ulcers), and in pregnancy screen in the 1st trimester with FPG, followed by confirmatory testing for normal 1st trimester results and structured follow-up for GDM.","https://schema.org",{"og:url":78,"og:type":114,"og:title":59,"og:site_name":86,"og:description":61},"article",{"robots":116,"canonical":78},"index,follow",{"doc_id":118,"site_id":56},563783,1791838401,{"code":4,"msg":5,"data":121},{"doc_id":118,"user_id":122,"nickname":83,"user_avatar":123,"doc_module":9,"category_id":45,"category_name":46,"doc_title":59,"doc_description":61,"doc_content":124,"file_id":125,"file_url":126,"file_type":127,"file_size":128,"view_count":4,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":129,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":130,"faqs":131,"seo_title":132,"seo_description":61,"update_tm":119,"read_time":4},687207022233,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","July/ 2022  \nDepartment of Health Research Ministry of Health and Family Welfare, Government of India  \nStandard Treatment Workflow (STW)  \nDIABETES MELLITUS TYPE 2  \nICD-10-E11  \nSYMPTOMS  \nMay be asymptomatic  \nOsmotic symptoms ie., polyuria, polydipsia and  \npolyphagia  \nWeight loss  \nNon healing wounds  \nRecurrent infections  \nBlurring of vision  \nParaesthesia  \nDIAGNOSIS  \n\n| | OR | | OR | | OR\u003Cbr>\u003Cbr>Diabetes symptoms + random plasma glucose ≥ 200 mg/dl |\n| --- | --- | --- | --- | --- | --- |\n| FPG ≥126\u003Cbr>mg/dl\u003Cbr>(after 8hr\u003Cbr>fasting) |  |  |  | HbA1C ≥\u003Cbr>6.5% |  |\n\nPREDIABETES:  \nImpaired fasting glucose: FPG 100-125 mg/dL; Impaired glucose tolerance: 140-199 mg/dL; HbA1c 5.7-6.4%  \nASSESS  \nCO-MORBIDITIES:  \nHypertension Dyslipidaemia  \nCAD CKD  \nBMI  \nEXAMINATION: waist circumference  \nBP  \nPeripheral pulses  \nPin-prick sensation, monofilament test ,vibration, DTR  \nSkin, oral cavity, foot  \nFundus (dilated) examination  \nINVESTIGATION  \n• HbA1c  \n• Creatinine  \n• K+  \n• Fasting lipid profile  \n• Urine routine examination and spot albumin: creatinine ratio\\#  \n• LFT/ ALT, AST  \n• ECG  \n• Others like Echo, USG abdomen as indicated  \n\\#These may best be carried out after initial glycaemic control  \nTREATMENT  \n• Dietary modification  \n• Avoidance of tobacco and restriction/ avoidance of alcohol  \n• Physical activity  \n• Pharmacotherapy:  \n› HbA1c \u003C 8.5%: Monotherapy-Metformin › HbA1c 8.5-10%: Dual therapy-Metformin + SU’s/TZD/ DPPIVi/SGLT2i /AGI/GLP-1RA › HbA1c > 10%: Basal Insulin+ Metformin + another OAD / triple OAD combination  \nMETABOLIC TARGETS  \n• HbA1c \u003C/= 7 .0%(except elderly and those with significant comorbid conditions) where higher target maybe acceptable  \n• Pre-prandial capillary plasma glucose: 80-130 mg/dl  \n• Post-prandial capillary plasma glucose: \u003C 180 mg/dl  \n• BP=140/90 (130/80 in CKD) LDL: \u003C 100 mg/dl (\u003C 70mg/dl in CAD)  \nMONITORING  \n• Blood glucose; FPG and 2 hours PPG once monthly more frequent as required including SMBG or CGM  \n• HbA1c every 6-12 months ( 3 monthly if uncontrolled)  \n• Annual monitoring : ECG, urine ACR (albumin creatinine ratio),dilated fundoscopy,foot examination  \nREFERRALS  \n• Endocrinology: for uncontrolled hyperglycemia  \n• Ophthalmology: at initial evaluation and every year  \n• Nephrology: for deranged renal function  \n• Cardiology: for CAD/HF/arrhythmia  \nSCREENING FOR DIABETES MELLITUS  \nIN AN APPARENTLY NORMAL ADULT  \n• In obese or overweight (BMI ≥ 27.5 or ≥ 23 kg/m2) with any of the following risk factors  \n• First degree relative with diabetes  \n• History of cardiovascular disease  \n• BP (≥ 140/90 mmHg)  \n• Dyslipidemia (TG > 250 mg/dL, HDL \u003C40 mg/dl in male, \u003C50 mg/dlin female  \n• Physical inactivity  \n• Polycystic ovary syndrome (PCOS)  \n• Insulin resistance (acanthosis nigricans)  \n• Adults > 30 years of age  \n• Previous history of GDM  \nIN AN ADULT WITH ILLNESS  \n• In any adult/adolescent who presents with one of the following illness/complaints  \n• Osmotic symptoms (polyuria, polydipsia, polyphagia, nocturia)  \n• Unexplained weight loss  \n• Unexplained depression or dementia  \n• Acute coronary syndrome  \n• Deep seated infections (liver abscess, lower lobe pneumonia, tuberculosis, pyelonephritis, abscesses, septic arthritis, osteomyelitis)  \n• Recurrent infections (tinea, oral thrush, onychomycosis, cystitis-urinary tract infection, sinusitis, STI, cellulitis, carbuncle)  \n• Non-healing ulcers (foot ulcers-infected/neuropathic)  \n• Exogenous/iatrogenic Cushing’s syndrome  \nIN PREGNANCY  \n• H/O GDM/Pre-existing diabetes  \n• All pregnant women to be screened in 1st trimester with FPG  \n• FPG ≥ 126 and/or HbA1c ≥ 6.5% to be considered pre-existing diabetes  \n• FPG between 92-125 to be considered as GDM  \n• All those women with normal screening in 1st trimester to get a 75 g-oral glucose tolerance test done at 24-28 weeks  \n• All GDM women to be tested 6 weeks post-partum and once every 3 years  \n• PREDIABETES: should be tested yearly  \nABBREVIATIONS  \nALT: Alanin","cbCaig5mh2O20d6g","https://ap.wps.com/l/cbCaig5mh2O20d6g","pdf",332368,"English","# Symptoms\n## Diagnosis\n## Prediabetes\n## Assessment and Examination\n## Investigations\n## Treatment\n## Metabolic Targets\n## Monitoring and Referrals\n## Screening for Diabetes Mellitus\n## Abbreviations","[{\"question\":\"What are the diagnostic criteria for Diabetes Mellitus Type 2?\",\"answer\":\"Diabetes is diagnosed using criteria such as random plasma glucose ≥ 200 mg/dl with symptoms, FPG ≥ 126 mg/dl after 8 hours fasting, or HbA1c ≥ 6.5%.\"},{\"question\":\"What metabolic targets should be followed for treatment?\",\"answer\":\"The workflow targets HbA1c ≤ 7.0% (with exceptions for elderly and significant comorbidities), pre-prandial capillary glucose 80–130 mg/dl, post-prandial glucose \\u003c 180 mg/dl, and BP and LDL targets (with lower LDL for CAD).\"},{\"question\":\"How should screening for diabetes be done in different populations?\",\"answer\":\"Screen apparently normal adults with obesity/overweight plus risk factors, screen ill adults presenting suggestive complaints (e.g., osmotic symptoms, recurrent infections, non-healing ulcers), and in pregnancy screen in the 1st trimester with FPG, followed by confirmatory testing for normal 1st trimester results and structured follow-up for GDM.\"}]","DIABETES MELLITUS TYPE 2 - Standard Treatment Workflow (STW) | PDF"]