Diagnosis of Type 2 Diabetes

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Glucose Testing and Interpretation: AACE Diagnostic Criteria

Test Result Diagnosis

FPG, mg/dL(measured after 8-hour fast)

≤99 Normal

100-125 Impaired fasting glucose

≥126Diabetes

Confirmed by repeat testing on a different dayPPG, mg/dL(measured with an OGTT performed 2 hours after 75-g oral glucose load taken after 8-hour fast)

≤139 Normal

140-199 Impaired glucose tolerance

≥200Diabetes

Confirmed by repeat testing on a different day

Random plasma glucose, mg/dL

With polyurea, polydipsia, or polyphagia

≥200 Diabetes

Hemoglobin A1C, %(screening only)

≤5.4 Normal

5.5-6.4 High risk/prediabetes

≥6.5Diabetes

Confirmed by repeat testing of FPG or PPG on a different day

FPG, fasting plasma glucose; OGTT, oral glucose tolerance test; PPG, postprandial glucose.Handelsman Y, et al. Endocr Pract. 2011;17(suppl 2):1-53.

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AACE. Endocrine Pract. 2010;16:155-156.

AACE Recommendations for A1C Testing

• A1C should be considered an additional optional diagnostic criterion, not the primary criterion for diagnosis of diabetes

• When feasible, AACE/ACE suggest using traditional glucose criteria for diagnosis of diabetes

• A1C is not recommended for diagnosing type 1 diabetes

• A1C is not recommended for diagnosing gestational diabetes

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AACE Recommendations for A1C Testing

• A1C levels may be misleading in several ethnic populations (for example, African Americans)

• A1C may be misleading in some clinical settings– Hemoglobinopathies– Iron deficiency– Hemolytic anemias– Thalassemias– Spherocytosis– Severe hepatic or renal disease

• AACE/ACE endorse the use of only standardized, validated assays for A1C testing

AACE. Endocrine Pract. 2010;16:155-156.

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Glucose Testing and Interpretation: ADA Diagnostic Criteria

Test Result Diagnosis

Hemoglobin A1C, %

≤5.6 Normal

5.7-6.4 High risk/prediabetes

≥6.5Diabetes

Confirmed by repeat testing in absence of unequivocal hyperglycemia

FPG, mg/dL(measured after 8-hour fast)

≤99 Normal

100-125 Impaired fasting glucose

≥126Diabetes

Confirmed by repeat testing in absence of unequivocal hyperglycemia

PPG, mg/dL(measured with an OGTT performed 2 hours after 75-g oral glucose load)

≤139 Normal

140-199 Impaired glucose tolerance

≥200Diabetes

Confirmed by repeat testing in absence of unequivocal hyperglycemia

Random plasma glucose, mg/dL, with polyurea, polydipsia, or polyphagia

≥200 Diabetes

FPG, fasting plasma glucose; OGTT, oral glucose tolerance test; PPG, postprandial glucose.ADA. Diabetes Care. 2013;36(suppl 1):S11-S66.

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