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Diabetes Mellitus C002

Last amended 
4 April 2016
Current RMA Instruments:
Consolidated RH SOP

89 of 2011 as amended by 88 of 2014 and 27 of 2016

Consolidated BOP SOP

90 of 2011 as amended by 89 of 2014 and 28 of 2016

Changes from previous Instruments:

SOP Bulletin 188

ICD Coding:
  • ICD-9-CM Codes: 250
  • ICD-10-AM Codes: E10, E11, E12, E13, E14
Brief description

Diabetes mellitus is a metabolic disorder characterized by high blood sugar levels. Most cases of diabetes mellitus can be classified as either type 1 or type 2.  Type 1 diabetes (5 to 10% of cases) results from the destruction of insulin secreting cells in the pancreas.  Type 2 diabetes (90 to 95% of cases) is due to resistance to the action of insulin by target tissues +/- some deficiency of insulin production.  Most patients with type 2 diabetes are obese. 

Confirming the diagnosis

Diagnosis requires confirmation by blood testing, for either plasma glucose level or HbA1c level, as specified in the SOP definition.

The relevant medical specialist is an endocrinologist or general physician.

There are factors in the SOP that apply only to type1 or type 2 diabetes, so information on the type of diabetes is required to apply those factors.

Additional diagnoses that are covered by this SOP
  • insulin dependent diabetes mellitus
  • non-insulin dependent diabetes mellitus
  • type 1 diabetes mellitus
  • type 2 diabetes mellitus
  • juvenile type diabetes mellitus
  • adult-onset type diabetes mellitus
  • secondary diabetes mellitus
Conditions not covered by SOP
  • gestational diabetes#
  • diabetes insipidus#

# non-SOP condition

Clinical onset

Clinical onset will be when the diagnosis is first confirmed by blood testing.  This is a threshold diagnosis, so any symptoms present prior to confirmation by blood testing will not establish a clinical onset.

Clinical worsening

The normal clinical course varies.  Type 2 diabetes may resolve with weight loss.  The more usual course is for slow progression of disease with the eventual development of complications or associated secondary diseases.