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:

    • A1C ≥5.7% (39 mmol/mol), impaired glucose tolerance, or impaired fasting glucose on previous testing

    • First-degree relative with diabetes

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

    • Women who were diagnosed with GDM

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

  3. 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 (e.g., those with prediabetes should be tested yearly) and risk status.