Screening

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.[66]

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 a history of diabetes in a first-degree relative, overweight or obesity, sedentary lifestyle, high-risk ancestry, gestational diabetes, hypertension (>140/90 mmHg or on therapy for hypertension), dyslipidemia (low high-density lipoprotein-cholesterol and/or elevated triglycerides), cardiovascular disease, prediabetes (HbA1c ≥5.7%, impaired glucose tolerance or impaired fasting glucose), polycystic ovary syndrome, other clinical conditions associated with insulin resistance (e.g., severe obesity, acanthosis nigricans or small-for-gestational-age birth weight) or HIV.[2]

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.[2]

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