American Diabetes Association (ADA) Guidelines: Criteria for Diabetes Diagnosis

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American Diabetes Association (ADA) Guidelines: Criteria for Diabetes Diagnosis

The American Diabetes Association's (ADA's) updated 2015 guidelines include recommendations for screening and criteria for the diagnosis of diabetes. 
The ADA recommends using these 4 criteria for diabetes diagnosis (4 testing options):
  1. Hemoglobin A1C ≥6.5%* - Perform in laboratory using National Glycohemoglobin Standardization Program (NGSP)-certified method and standardized to the Diabetes Control and Complications Trial (DCCT) assay.
  2. Fasting plasma glucose  (FPG) ≥126 mg/dL (7.0 mmol/L)* -  Fasting defined as no caloric intake for ≥8 hours.
  3. 2-hour plasma glucose (PG) ≥200 mg/dL (11.1 mmol/L) during oral glucose tolerance test (OGTT) (75-g)* - Performed as described by the World Health Organization (WHO), using glucose load containing the equlivalent of 75 g anhydrous glucose dissolved in water. 
  4. Random plasma glucose (PG) ≥200 mg/dL (11.1 mmol/L) - In persons with symptoms of hyperglycemia or hyperglycemic crisis.
* In the absence of unequivocal hyperglycemia results should be confirmed using repeat testing.
* Unless clinical diagnosis is clear, same test to be repeated using a new blood sample for confirmation.
* Two discordant results? Result above cutpoint should be repeated.
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. 

ADA diabetes diagnosis guidelines 2015