Diagnosis and Assessment
Table 1. Categories of Increased Risk for Diabetes (Prediabetes)a
Test Impaired fasting glucose (IFG) A1c Parameters FPG 100-125 mg/dL (5.6-6.9 mmol/L)
Impaired glucose tolerance (IGT) 2-h plasma glucose in the 75-g OGTT 140-199 mg/dL (7.8-11.0 mmol/L)
5.7-6.4%
a For all three tests, risk is continuous, extending below the lower limit of the range and becoming disproportionately greater at higher ends of the range.
Table 2. Criteria for Testing for Diabetes in Asymptomatic Adult Individuals
ÎTesting should be considered in all adults who are overweight (BMI ≥ 25 kg/m2
)a and have additional risk factors:
> Physical inactivity > First-degree relative with diabetes > High-risk race/ethnicity (eg, African American, Latino, Native American, Asian American, Pacific Islander)
> Women with polycystic ovarian syndrome (PCOS) > A1c ≥ 5.7%, IGT, or IFG on previous testing > Other clinical conditions associated with insulin resistance (eg, severe obesity, acanthosis nigricans) > History of CVD
(0.90 mmol/L) and/or a triglyceride level > 250 mg/dL (2.82 mmol/L)
ÎIn the absence of the above criteria, testing for diabetes should begin at age 45 years.
ÎIf results are normal, testing should be repeated at least at 3-year intervals, with consideration of more frequent testing depending on initial results and risk status.
a At-risk BMI may be lower in some ethnic groups.
> Women who delivered a baby weighing > 9 lb or were diagnosed with GDM > Hypertension (≥ 140/90 mmHg or on therapy for hypertension) > HDL cholesterol level < 35 mg/dL
