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Screening for Type 2 Diabetes

by Karen Schroeder Kassel, MS, RD, MEd

The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.

Prediabetes is characterized by high blood glucose levels that are not high enough to be diagnosed as diabetes. But the condition often progresses to type 2 diabetes.

In order to detect prediabetes and type 2 diabetes, the American Diabetes Association (ADA) recommends the following guidelines:

Screen adults of any age who are overweight or obese with one or more of these risk factors:
- First-degree relative with diabetes
- Low HDL (good) cholesterol level and high triglycerides levels
- High blood pressure
- History of diabetes during pregnancy ( gestational diabetes) or having a baby weighing over nine pounds (4.1 kg)
- Having polycystic ovary syndrome or other conditions associated with insulin resistance
- Being inactive
- History of cardiovascular disease
- Belonging to an at-risk ethnic group (African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander)
- Previous blood test results that show hemoglobin A1c (HbA1c) levels at 5.7% or higher, impaired glucose tolerance, and impaired fasting glucose
Screen adults aged 45 and older with or without risk factors
Screen overweight children aged 10 years and older who have two or more of the following risk factors:
- Family history of diabetes
- Mother with diabetes or gestational diabetes
- Signs of insulin resistance or having a condition associated with insulin resistance
- At-risk ethnic background

If the results are normal for both adults and children, the ADA recommends screening again in three years.

The HbA1c test is a good indicator of your average blood glucose levels over the past 2-4 months. This test usually does not require any dietary restrictions.

Diagnosis	HbA1c Level
Prediabetes	5.7%-6.4%
Diabetes	6.5% or higher

With this blood test, you need to fast (not eat anything) for at least eight hours before the test.

Diagnosis	Fasting Plasma Glucose Level
Prediabetes	100-125 mg/dL (5.6-6.9 mmol/L)
Diabetes	126 mg/dL (7 mmol/L) or higher

After fasting overnight, the doctor tests your glucose level. You are then asked to drink 75 grams of glucose dissolved in water. Two hours later, the doctor tests your glucose level again.

Diagnosis	Glucose Levels
Prediabetes	140-199 mg/dL (7.8-11 mmol/L)
Diabetes	200 mg/dL (11.1 mmol/L) or higher

Diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated August 2, 2012. Accessed December 31, 2012.

Diabetes statistics. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/diabetes-statistics/?loc=DropDownDB-stats. Accessed December 31, 2012.

Glucose. Lab Tests Online website. Available at: http://labtestsonline.org/understanding/analytes/glucose/tab/test. Updated March 23, 2012. Accessed December 31, 2012.

Prediabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated August 2, 2012. Accessed December 31, 2012.

2/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-61).

2/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-69).

Last reviewed November 2012 by Kim Carmichael, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.