2.2 Evaluation of CP Patients for Presence or Incr...
Currently，investigations for pancreatic endocrine dysfunction mainly consist of fasting serum glucose，oral glucose tolerance test，serum glycosylated hemoglobin（HbAlc），and serum C-peptide（Sze et al.2014）.Pancreas Fest 2012 recommends that fasting serum glucose and HbAlc tests should be repeated annually as initial evaluation.The diagnosis of increased risk or the presence of diabetes is as per endocrinology guidelines such as American Diabetes Association guidelines（Rickels et al.2013；Andersen 2012）.When impairment either in fasting glucose or in HbAlc is found，a standard 75g oral glucose tolerance test（OGTT）should be commenced to further clarify the diagnosis（Rickels et al.2013）.In line with the predominant insulin deficiency in T3cDM patients，hyperglycemia mainly manifests in the postprandial stage in these patients，whereas fasting hyperglycemia develops later.Thus，based on results of fasting glucose or HbAlc levels，T3cDM may easily be overlooked.In contrast，OGTT provides a more accurate diagnosis.A recent study demonstrated that whenβ-cells was reduced by 64%，diabetes could be diagnosed based on OGTT 2-h glucose levels.Whereas，a mean β-cells loss of 89-93%were needed when the HbAlc and fasting glucose were adopted as diagnostic criteria，respectively（Meier et al.2012）.(https://www.daowen.com)