Type 2 diabetes screening
Type 2 diabetes testing should be done in all adults who are overweight or obese (BMI
≥25 or ≥23 in Asian Americans) who have one or more diabetes risk factors, including:
- Physical Inactivity
- First-degree relative with diabetes
- High-risk race/ethnic group
- Women who delivered a baby >9 pounds or were diagnosed with gestational diabetes (GDM)
- High-density lipoprotein cholesterol (HDL-C) <35 mg/dL ± triglyceride (TG) >250
- Hypertension (≥140/90 mm Hg or on therapy)
- A1C ≥5.7%, impaired glucose tolerance (IGT), or impaired fasting glucose (IFG) on previous testing
- Conditions associated with insulin resistance (eg, severe obesity, acanthosis nigricans, polycystic ovarian syndrome)
- Cardiovascular disease (CVD) history
The ADA recommends that testing should begin at age 45, especially if the individual is overweight or obese.
If results are negative/normal, then repeat testing in ≥3 year intervals. Prediabetes testing can be done
using Hgb A1C, FPG, or 2-h PG after 75-g OGTT. In addition, prediabetes testing should be considered in children and adolescents who are overweight/obese and have two or more diabetes risk factors.
Note: A more detailed discussion and review of laboratory test methods is presented in the section on Laboratory Assays in Evaluating Diabetic Patients.