Table 1 Revised type 2 diabetes vascular staging instrument with detailed classification items and their measures

Detailed classification item

Measures (Australian Refined Diagnosis Related Group code version 5.0^* or clinical reference range)

1

Diagnosis of type 2 diabetes

Doctor diagnosis confirmed by a medical chart audit or a fasting blood glucose level ≥ 7 mmol/L^† or 2-hour glucose tolerance test result of blood glucose level ≥ 11.1 mmol/L ^†[10] or a hospital admission for diabetes

With no evidence of microvascular or macrovascular risk factors (but may be obese or report current tobacco smoking)

Albumin creatinine ratio (ACR) within normal range

ACR of 0–2.5 mg/mmol for men and 0–3.5 mg/mmol for women^‡

Normal high density lipoprotein cholesterol (HDLC)

> 1.0 mmol/L^§

Normal triglycerides

< 1.5 mmol/L^§

Not hypertensive

Not hospitalised for hypertension (DRG code F67A or F67B), or blood pressure < 140/90 mmHg ^||

No evidence of retinopathy

Not hospitalised for retinal procedures and vascular disorders of the eye (DRG code C03Z or C16Z)

Peripheral sensation normal and no evidence of claudication

Not hospitalised for DRG code F65A or F65B

No cardiac disease

Not hospitalised for DRG code A05Z, F12Z, F14A, F14B, F62Z, F62B, F70A, F70B, F62A, F14C, F15Z, F16Z, F17Z, F18Z, F19Z, F10Z, F41A, F41B, F60A, F60B or F60C

2

Screen-detected microvascular comorbidities and/or risk factors for macrovascular disease

Microalbuminuria

ACR 2.6–25 mg/mmol for men and 3.6-35 mg/mmol for women^‡

Reduced HDLC

≤ 1.0 mmol/L^§

Elevated triglycerides

≥ 1.5 mmol/L^§

Hypertension

Hospitalised for DRG code F67A or F67B, or systolic blood pressure ≥ 140 mm Hg and/or a diastolic blood pressure ≥ 90 mm Hg^||

3

Moderate microvascular and/or macrovascular comorbidities

Macroalbuminuria

ACR > 25 mmol/L for men and > 35 mmol/L for women^‡

History of coronary artery bypass graft or angioplasty

F05A, F05B, F06A, F06B

History of carotid artery disease

F66A, F66B

History of or hospitalised for angina

F72A, F72B

History of claudication or peripheral vascular disease

F65A, F65B

4

Late-stage diabetes macrovascular and/or microvascular comorbidities

Amputation of lower limb

F11A, F11B, F13Z, I07Z, I14Z

Present or history of gangrene of the lower limb

J13A, J13B, J64A, J64B

History of stroke with residual deficit

B69A, B69B, B70A, B70B, B70C, B70D

History of or hospitalised for cardiac failure

A05Z, F12Z, F14A, F14B, F62A, F62B, F70A, F70B

History of myocardial infarction

F14C, F15Z, F16Z, F17Z, F18Z, F19Z, F10Z, F41A, F41B, F60A, F60B, F60C

Proliferative retinopathy and both eyes: only able to perceive light or hand movement or count fingers, or unable to perceive light

C03Z, C16Z

Present or history of osteomyelitis or ulcer of the foot or charcot joint

I64A, I64B

Bacterial soft tissue infection of the foot

J12A, J12B, J12C,

History of painful neuropathy or autonomic neuropathy other than erectile impotence

K01Z

History of end-stage renal failure

L60A, L60B, L60C

History of dialysis

L61Z

History of renal transplant

A09A, A09B