Nonmodifiable and modifiable risk factors, along with medical conditions, should be carefully considered in assessing an individual’s risk for developing T2D. As early interventions in individuals with impaired glucose tolerance or prediabetes can delay the onset of type 2 diabetes (T2D) and have long-term survival benefits, screening is strongly recommended when appropriate.1
The 2021 diagnostic guideline by the American Diabetes Association (ADA) provides the following screening recommendations for T2D or prediabetes in asymptomatic adults who meet any one of the following criteria.2
- Adults who are overweight or obese (body mass index (BMI) >25 kg/m2 or >23 kg/m2 in Asian Americans) with >1 of the risk factors below should be tested, and screening should be repeated <3 years if results are normal
- First degree relative (ie, parents, siblings, or offspring) with diabetes
- High-risk racial/ethnic background
- Eg, Asian American, African American, Pacific Islander, Latino, Native American
- History of cardiovascular disease
- Eg, stroke, congestive heart failure, etc.
- High blood pressure (>140/90 mmHg)
- Triglyceride level >250 mg/dL and/or high-density lipoprotein (HDL) cholesterol level <35 mg/dL
- Women with polycystic ovary syndrome
- Physical inactivity
- Other medical conditions associated with insulin resistance
- Eg, acanthosis nigricans, severe obesity
- Adults with prediabetes, defined as having glycosylated hemoglobin (HbA1c) >7%, should be tested every year
- Women diagnosed with gestational diabetes should be tested every <3 years
For all other adults, screening for T2D should begin at age 45 and should be repeated every <3 years. Testing can be done more frequently based on changes in risk factors or medical conditions.
Other major expert groups such as the U.S. Preventive Services Task Force (USPSTF)3 and the Centers for Disease Control and Prevention (CDC)4 provide similar screening recommendations. It should be noted that the USPSTF provides a broader approach, recommending all adults 40-70 years of age who are overweight or obese to be tested every 3 years.3
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