Instructions
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Diagnostic Criteria Now let's take a look at the diagnostic criteria used for type-2 diabetes.
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People with pre-diabetes (impaired glucose tolerance or impaired
fasting glucose) are at a higher risk for developing type-2
diabetes.
Pre-diabetes refers to blood glucose levels that are higher than
normal but not high enough to be diagnosed as diabetes. Most
people with pre-diabetes develop type-2 diabetes within 10
years. The ADA estimates that 41 million Americans have
pre-diabetes.
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Recent studies indicate that treating pre-diabetes may prevent
or delay type-2 diabetes.
Lifestyle changes that include modest weight loss and regular
physical activity have been shown to delay or prevent the onset
of type-2 diabetes. The antidiabetes drug metformin also has
been shown to be beneficial in preventing type-2 diabetes in
some people.
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Blood tests are used to determine if a person has pre-diabetes
or diabetes.
The fasting plasma glucose test (FPGT) and the oral glucose
tolerance test (OGTT) both require a person to fast overnight.
In the FPGT, which is the test of choice, blood glucose is
measured in the morning before eating. In the OGTT, blood
glucose is measured after fasting and 2 hours after drinking a
glucose load (high-glucose drink). As shown in the slide, blood
glucose values from these tests are used to diagnose
pre-diabetes and diabetes. In most people, the results need to
be confirmed by repeat testing on a different day.
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People should check with their health care providers to
determine if they need screening for pre-diabetes.
The ADA recommends screening for people who are overweight and
age 45 or older, and for those who have other risk factors for
diabetes, such as a family history of diabetes, a history of
gestational diabetes, or belonging to an ethnic or minority
group at increased risk of diabetes, including African
Americans, Native Americans, Hispanics, Asians, and Pacific
Islanders. Note that the American College of Endocrinology (ACE)
and the American Association of Clinical Endocrinologists (AACE)
recommend that the guideline for diabetes screening be reduced
to age 30 for high-risk groups. People who have any overt
symptoms of diabetes should see their health care team for a
diagnostic evaluation.
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