Criteria for testing for diabetes or prediabetes
1. Testing should be considered in all adults who are overweight with a Body Mass Index (BMI) of 25 or more or 23 in Asian Americans and have additional risk factors:
- Physical inactivity
- First-degree relative with diabetes
- High-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander)
- Women who delivered a baby weighing > 9 lb or were diagnosed with Gestational Diabetes Mellitus
- Hypertension (>140/90 mmHg or on therapy for hypertension)
- HDL cholesterol level <35 mg/dL and/or a triglyceride level >250 mg/dL
- Women with polycystic ovary syndrome
- A1C of greater than or equal to 5.7%, Impaired Glucose Tolerance, or Impaired Fasting Glucose on previous testing
- Other clinical conditions associated with insulin resistance (e.g., severe obesity, acanthosis nigricans)
- History of Cardiovascular Disease
2. Testing is recommended for those over the age of 45, particularly those who are overweight or obese.
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.
How is diabetes diagnosed?
Diabetes is diagnosed with a fasting blood glucose or an A1c blood test, also known as a glycated hemoglobin test. A fasting blood sugar test is performed after you have had no caloric intake from food or beverages for at least 8 hours. Normal fasting blood sugar is less than 100 mg/dl. You do not have to be fasting for an A1c blood test and the test should be performed in a laboratory using a method that is certified by the National Glycohemoglobin Standardization Criteria for the diagnosis of Diabetes Mellitus.
The following criteria are used for identifying prediabetes and diabetes mellitus:
- Fasting plasma glucose between 100 and 125 mg/dl or
- 2-hour plasma glucose in the 75 gram oral glucose tolerance test 140 - 199 mg/dl or
- A1C of 5.7 - 6.4%
- Fasting plasma glucose of 126 mg/dL or more or
- 2-h plasma glucose of 200 mg/dL or more during an oral glucose tolerance test using a beverage containing 75 grams of glucose or
- A1C of 6.5% or more.
What are the symptoms of diabetes?
The symptoms of diabetes may include:
- Increased thirst
- Increased hunger
- Dry mouth
- Frequent urination
- Unexplained weight loss (even though you are eating enough)
- Weak, tired feeling
- Blurred vision
- Numbness or tingling of the hands and/or feet
- Slow healing sores or cuts
- Dry and itchy skin (usually in the vaginal or groin area)
- Frequent yeast infections