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ADA Testing Guidelines for Type 2 Diabetes and Prediabetes in Asymptomatic Adults

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 mg/dL 
  • 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
Prediabetes screening 
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.
Source: Diabetes management guidelines (2015). National Diabetes Education Initiative web site. Available at: http://www.ndei.org/ADA-diabetes-management-guidelines-diagnosis-A1C-testing.aspx. Accessed February 17, 2016.
Note: A more detailed discussion and review of laboratory test methods is presented in the section on Laboratory Assays in Evaluating Diabetic Patients.