Table 2.3

Criteria for testing for diabetes or prediabetes in asymptomatic adults

  1. Testing should be considered in overweight or obese (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) adults who have one or more of the following risk factors:

    • First-degree relative with diabetes

    • High-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander)

    • History of CVD

    • Hypertension (≥140/90 mmHg or on therapy for hypertension)

    • HDL cholesterol level <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L)

    • Women with polycystic ovary syndrome

    • Physical inactivity

    • Other clinical conditions associated with insulin resistance (e.g., severe obesity, acanthosis nigricans)

  2. Patients with prediabetes (A1C ≥5.7% [39 mmol/mol], IGT, or IFG) should be tested yearly.

  3. Women who were diagnosed with GDM should have lifelong testing at least every 3 years.

  4. For all other patients, testing should begin at age 45 years.

  5. If results are normal, testing should be repeated at a minimum of 3-year intervals, with consideration of more frequent testing depending on initial results and risk status.

  • CVD, cardiovascular disease; GDM, gestational diabetes mellitus.