What are the recommendations for type 2 diabetes mellitus (DM) screening in asymptomatic adults?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

The U.S. Preventive Services Task Force recommends screening for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg (grade B recommendation). [3]

The ADA recommends considering testing for prediabetes and diabetes in asymptomatic adults who are overweight (body mass index [BMI] ≥25 kg/m2; may be lower in at-risk ethnic groups) and have 1 or more of the following additional risk factors [2] :

  • Physical inactivity

  • First-degree relative with diabetes

  • Member of a high-risk ethnic population (eg, African American, Latino, Native American, Asian American, Pacific Islander)

  • Delivered a baby weighing over 9 lb or diagnosed with gestational diabetes mellitus

  • Hypertension (≥140/90 mm Hg or on therapy for hypertension)

  • HDL cholesterol level under 35 mg/dL (0.90 mmol/L) and/or a triglyceride level above 250 mg/dL (2.82 mmol/L)

  • Polycystic ovary disease

  • IGT or IFG on previous testing

  • Other clinical conditions associated with insulin resistance (eg, severe obesity, acanthosis nigricans)

  • History of cardiovascular disease

In the absence of the above criteria, the ADA recommends testing for prediabetes and diabetes beginning at age 45 years. If results are normal, testing should be repeated at least every 3 years. More frequent testing may be considered, depending on initial results and risk status.


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