5
Table 4. Criteria for Testing for Diabetes in Asymptomatic
Adult Individuals
Î Testing should be considered in all adults who are overweight
(BMI ≥25 kg/m
2
)
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 who delivered a baby weighing >9 lb or were diagnosed with GDM
• Hypertension (≥140/90 mmHg or on therapy for hypertension)
• High-density lipoprotein cholesterol (HDL-C) level <35 mg/dL
(0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L)
• Women with polycystic ovarian syndrome
• A1c ≥5.7%, IGT, or IFG on previous testing
• Other clinical conditions associated with insulin resistance (eg, severe obesity,
acanthosis nigricans)
• History of cardiovascular disease (CVD)
Î In the absence of the above criteria, testing for diabetes should
begin at age 45 years.
Î If results are normal, testing should be repeated at least at 3-year
intervals, with consideration of more frequent testing depending on
initial results (e.g., those with prediabetes should be tested yearly)
and risk status.
a
At-risk BMI may be lower in some ethnic groups.
Testing for Diabetes in Asymptomatic Patients
Î Testing to detect type 2 diabetes and assess risk for future diabetes
in asymptomatic people should be considered in adults of any age who
are overweight or obese (BMI ≥25 kg/m
2
) and who have one or more
additional risk factors for diabetes (Table 4). (B)
Note: In those without these risk factors, testing should begin at age 45 years. (B)
Î To test for diabetes or prediabetes, the A1c, FPG, or 2-h 75-g OGTT
are appropriate. (B)
Î In those identified with prediabetes, identify and, if appropriate, treat
other CVD risk factors. (B)
Detection and Diagnosis of Gestational Diabetes Mellitus (GDM)
Î Screen for undiagnosed type 2 diabetes at the first prenatal visit in
those with risk factors, using standard diagnostic criteria. (B)
Î In pregnant women not previously known to have diabetes, screen for
GDM at 24-28 weeks gestation. (A)
