Executive Summary: Standards of Medical Care in Diabetes—2012

Current criteria for the diagnosis of diabetes

  • A1C ≥6.5%. The test should be performed in a laboratory using a method that is National Glycohemoglobin Standardization Program (NGSP)-certified and standardized to the Diabetes Control and Complications Trial (DCCT) assay; or

  • fasting plasma glucose (FPG) ≥126 mg/dL (7.0 mmol/l). Fasting is defined as no caloric intake for at least 8 h; or

  • 2-h plasma glucose ≥200 mg/dL (11.1 mmol/l) during an oral glucose tolerance test (OGTT). The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water; or

  • in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/l);

  • in the absence of unequivocal hyperglycemia, the result should be confirmed by repeat testing.

Testing for diabetes in asymptomatic patients

  • Testing to detect type 2 diabetes and to assess risk for future diabetes in asymptomatic people should be considered in adults of any age who are overweight or obese (BMI ≥25 kg/m2) and who have one or more additional risk factors for diabetes (see Table 4 of the “Standards of Medical Care in Diabetes—2012”). In those without these risk factors, testing should begin at age 45 years. (B)

  • If tests are normal, repeat testing at least at 3-year intervals is reasonable. (E)

  • To test for diabetes or to assess risk of future diabetes, A1C, FPG, or 2-h 75-g OGTT are appropriate. (B)

  • In those identified with increased risk for future diabetes, identify and, if appropriate, treat other cardiovascular disease (CVD) risk factors. (B)

Detection and diagnosis of gestational diabetes mellitus (GDM)

  • Screen for undiagnosed type 2 diabetes at the first prenatal visit in those with risk factors, using standard diagnostic criteria. (B)

  • In pregnant women not previously known to have diabetes, screen for GDM at 24-28 weeks gestation, using a 75-g 2-h OGTT and the diagnostic cutpoints in Table …

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This Article

  1. doi: 10.2337/dc12-s004 Diabetes Care vol. 35 no. Supplement 1 S4-S10