Diabetes mellitus type 2 diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]

Overview

Fasting plasma glucose, 2-h plasma glucose during 75-g oral glucose tolerance test, and A1C are equally appropriate in diagnosing diabetes mellitus type 2.

Diagnostic recommendation

According to the ADA criteria, fasting plasma glucose, 2-h plasma glucose during 75-g oral glucose tolerance test, and A1C are equally appropriate in diagnosing diabetes mellitus type 2.[1]

ADA Recommendation For Diagnosis of Diabetes Mellitus Type 2
  • For all people, testing should begin at age 45 years.
  • If tests are normal, repeat testing carried out at a minimum of 3-year intervals is reasonable.
  • Testing for type 2 diabetes should be considered in children and adolescents who are overweight or obese (BMI >85th percentile for age and sex, weight for height >85th percentile, or weight >120% of ideal for height) and who have additional risk factors for diabetes
Adapted from American Diabetes Association (ADA)

Diagnostic criteria

American Diabetes Association (ADA) criteria for the diagnosis of type 2 DM follows:[2][3][4]

American Diabetes Association (ADA) Criteria for the Diagnosis of Diabetes
FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 hours.*
OR
2-hours PG ≥200 mg/dL (11.1 mmol/L) during an OGTT. The test should be performed as described by the WHO, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.*
OR
A1C ≥6.5% (48 mmol/mol). The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay.*
OR
In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L).
Adapted from American Diabetes Association (ADA)
  •  In the absence of unequivocal hyperglycemia, results should be confirmed by repeat testing.

References

  1. "2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes—2018". Diabetes Care. 41 (Supplement 1): S13–S27. 2017. doi:10.2337/dc18-S002. ISSN 0149-5992.
  2. Nguyen Q, Nguyen L, Felicetta J (October 2008). "Evaluation and management of diabetes mellitus". Am Health Drug Benefits. 1 (8): 39–48. PMC 4106505. PMID 25126259.
  3. "Standards of medical care in diabetes--2008". Diabetes Care. 31 Suppl 1: S12–54. January 2008. doi:10.2337/dc08-S012. PMID 18165335.
  4. Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, Lernmark A, Metzger BE, Nathan DM (June 2011). "Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus". Diabetes Care. 34 (6): e61–99. doi:10.2337/dc11-9998. PMC 3114322. PMID 21617108.