Optimal cutpoints for defining diabetes differ according to how diabetes itself is defined. When diabetes is defined as the upper component of the bimodal population distribution, a fasting glucose level somewhat lower than the current WHO cutpoint and a 2-h glucose level somewhat higher than the current WHO cutpoint minimized misclassification. When diabetic retinopathy defines diabetes, we found that the current fasting diagnostic criterion favors specificity and the current 2-h criterion favors sensitivity. These results should prove valuable for defining the optimal tests and cutpoint values for diagnosing diabetes.

Adjusting random capillary blood glucose measurements for the postprandial period and using age-specific cutoff point values can improve performance of the screening test.

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Background: Malnutrition is a common complication of the end-stage liver disease and associated with increased morbidity and mortality rates. Numerous studies have proved that pre-operative malnutrition is related to higher risk of surgical morbidities and mortalities in general surgical patients. Mal-nourished patients tend to have high rates of infectious complications, prolonged intensive care unit (ICU) stay, hospital stay and increased mortality. Aim of Study: To determine the impact of nutritional status pre-liver transplant on recipients' course and the outcome post-transplant. Patients and Methods: Pre-operative nutritional assessment with Subjective global assessment (SGA) was done retrospectively for 52 patients, categorized as well-nourished, mild, moderate and severe mal-nourished and followed for postoperative course. Results: The causes of transplant were mainly decompensated chronic liver disease (46.2%), hepato-cellular carcinoma (32.7%) and auto-immune with HCC (11.5%). As a result of all these complications, the ICU stay, hospital stay, 28 day mortality were less in well-nourished patients in comparison to the mal-nourished one. Conclusion: The nutritional status pre-liver transplant is an important factor which can affect the outcome of the liver transplant patients. The mal-nourished patients showed a higher incidence of post-operative sepsis, a higher postoperative bilirubin levels, a more need for post-operative nutritional intervention, a higher incidence of need of reintubation for mechanical ventilation, a higher incidence of post-operative renal impairment and neurological complications. As a result of all these complications, the ICU stay, hospital stay, 28 day mortality were less in well-nourished patients in comparison to the mal-nourished one. So, preoperative assessment and optimizing the nutritional status is an essential step before proceeding for surgery.

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