The US Preventive Services Task Force (USPSTF) now recommends screening for glucose status for adults ages 40 to 70 years who have body mass index (BMI) ≥25. Those with normal test results should be re-screened every 3 years. Those who have prediabetes should subsequently be screened annually for diabetes.
The American Diabetes Association has recommended routine screening of nonpregnant asymptomatic adults of any age with BMI ≥25 kg/m² (≥23 kg/m² for Asian-Americans) plus one or more risk factors for diabetes. Those without risk factors should be screened starting at age 45 years. Risk factors for diabetes include family history of diabetes, overweight or obesity, sedentary lifestyle, high-risk ancestry, gestational diabetes, hypertension, dyslipidemia (low high-density lipoprotein-cholesterol and/or elevated triglycerides), vascular disease, glucose intolerance, or polycystic ovary syndrome.
Recommended screening tests include fasting plasma glucose (prediabetes if 100-125 mg/dL once, in the absence of diabetes) and/or HbA1c (prediabetes if 5.7% to 6.4% once, in the absence of diabetes; diabetes if ≥6.5% twice). Oral 75 g glucose tolerance test is less commonly used in nonpregnant adults.
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