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:
 • First-degree relative with diabetes
 • High-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander)
 • 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. Patients with prediabetes (A1C ≥5.7% [39 mmol/mol], IGT, or IFG) should be tested yearly.
3. Women who were diagnosed with GDM should have lifelong testing at least every 3 years.
4. For all other patients, testing should begin at age 45 years.
5. 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 and risk status.
  • IFG, impaired fasting glucose; IGT, impaired glucose tolerance.