Executive Summary: Standards of Medical Care in Diabetes—2014

A1C ≥6.5%. The test should be performed in a laboratory using a method that is NGSP certified and standardized to the 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

Two-hour 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, result should be confirmed by repeat testing.

Testing to detect type 2 diabetes and prediabetes 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. 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 prediabetes, the A1C, FPG, or 2-h 75-g OGTT are appropriate. B

In those identified with prediabetes, identify and, if appropriate, treat other cardiovascular disease (CVD) risk factors. B

Testing to detect type 2 diabetes and prediabetes should be considered in children and adolescents who are overweight and who have two or more additional risk factors for diabetes. E

Inform type 1 diabetic patients of the opportunity to have their relatives screened for type 1 diabetes risk in the setting of a clinical research study. E

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

Screen for gestational …