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Last Updated: 3/16/2015  

Screening for Type 2 Diabetes

  • Know that there is no direct evidence that screening for type 2 diabetes improves health outcomes of mortality rates.

  • Screen all adults with CVD, hypertension, dyslipidemia, or other CVD risk factors for diabetes.

  • Understand that there is insufficient evidence for diabetes screening in adults without CVD risk factors.

  • Consider screening for diabetes in adults 18 years or older with risk factors for type 2 diabetes (family history, obesity, gestational diabetes, polycystic ovary syndrome, high-risk ethnic group).

  • Recognize that although there is no direct evidence about screening intervals, expert panels have recommended screening every 3 years.

  • Use the FBG test to screen for diabetes because it is easier to administer, is less costly, and is more reproducible than the 75-g OGTT to detect diabetes; consider using HbA1c to screen for diabetes

  • Consider performing a 75-g OGTT in individuals with an FBG of 100 to 126 mg/dL (5.6 to 7.0 mmol/L), as diabetes cannot be adequately confirmed or excluded with FBG values within that range.

  • Appreciate that the HbA1c test has high specificity but only moderate sensitivity to diagnose diabetes.

DOI: 10.7326/s370
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Author(s) and Disclosures:
Lorraine Lipscombe, MD, FRCPC has nothing to disclose. Denice Feig, MD, MSc, FRCPC has nothing to disclose. Sonal Singh, MD has nothing to disclose.

One or more of the present or past ACP Smart Medicine physician editors worked on this module and had nothing to disclose: Davoren Chick, MD, FACP; Deborah Korenstein, MD, FACP; Marjorie Lazoff, MD, FACP; Richard Lynn, MD, FACP.

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