- Testing should be considered in adults with overweight or obesity (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) who have 1 or more of the following risk factors:
- First-degree relative with diabetes
- High-risk race/ethnicity (eg, African American, Latino, Native American, Asian American, Pacific Islander)
- History of CVD
- Hypertension (≥130/80 mmHg or on therapy for hypertension)
- HDL cholesterol level <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L)
- History of PCOS
- Physical inactivity
- Other clinical conditions associated with insulin resistance (eg, severe obesity, acanthosis nigricans)
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- Patients with prediabetes (A1C ≥5.7% [39 mmol/mol], IGT, or IFG) should be tested yearly.
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- Patients with a history of GDM should have lifelong testing at least every 3 years.
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- For all other patients, testing should begin at age 35 years.
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- If results are normal, testing should be repeated at a minimum of 3-year intervals, with consideration of more frequent testing depending on initial results and risk status.
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- Persons with HIV, exposure to high-risk medicines, or history of pancreatitis.
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