RISK FACTORS FOR DIABETES

45 years and over.
High lipids.
Hypertension.
Sedentary lifestyle.
A history of vascular disease.
Gestational diabetes mellitus.
Polycystic ovary syndrome.
Overweight or a body mass index (BMI) over 25.
Diagnosed diabetes mellitus in a first-degree relative.
A1C ≥5.7 percent, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).
Are from a high risk ethnic/racial group i.e.; African-American, Hispanic, Native American, Asian-American and Pacific Islanders

 

DIABETES SCREEN RECOMMENDATIONS

The Centers for Disease Control and Prevention (CDC) in the United States suggests screening by fasting glucose, Oral glucose tolerance test, or A1C testing for individuals 45 years or older or those with risk factors, including overweight, first-degree relative with diabetes, high-risk ethnic group, history of gestational diabetes or sedentary lifestyle.

The American Diabetes Association (ADA) recommends testing at three-year intervals for diabetes or pre-diabetes in all adults with a body mass index (BMI) of ≥25 kg/m2 or ≥23 kg/m2 in Asian-Americans; and one or more additional risk factors for diabetes using either A1C, fasting plasma glucose, or a two-hour oral glucose tolerance test (OGTT). For individuals without risk factors, the ADA recommends testing begins at 45 years of age.

The US Preventive Services Task Force (USPSTF) recommends screening for abnormal glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. The USPSTF suggests screening every three years based on limited health evidence.

The Canadian Task Force on Preventive Health Care (CTFPHC) recommends using a validated risk calculator to identify people at high risk for diabetes. It recommends not routinely screening individuals at low to moderate risk for diabetes and screening individuals at increased risk with A1C, to be repeated every three to five years for those at high risk and yearly for those at very high risk.

In the United Kingdom, guidelines issued in 2012 recommend risk assessment using a self-assessment questionnaire or risk-assessment tool for diabetes for adults aged 40 and above, younger adults in high-risk ethnic groups, those with a BMI of >30 kg/m2, or those with co-morbidities including hypertension or cardiovascular disease. A typical test includes either a fasting plasma glucose or A1C, providing the individual with a program for lifestyle change based on the findings.