Executive Summary: Standards of Medical Care in Diabetes—2011

Abstract

Standards of Medical Care in Diabetes-2011Current criteria for the diagnosis of diabetes • A1C Ն6.5%.The test should be performed in a laboratory using a method that is National Glycohemoglobin Standardization Program (NGSP)-certified and standardized to the Diabetes Control and Complications Trial (DCCT) assay • fasting plasma glucose (FPG) Ն126 mg/dl (7.0 mmol/l).Fasting is defined as no caloric intake for at least 8 h, or • 2-h plasma glucose Ն200 mg/dl (11.1 mmol/l) during an oral glucose tolerance test (OGTT).The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water • in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose Ն200 mg/dl (11.1 mmol/l) • in the absence of unequivocal hyperglycemia, result should be confirmed by repeat testing.Testing for diabetes in asymptomatic patients • Testing to detect type 2 diabetes and assess risk for future diabetes in asymptomatic people should be considered in adults of any age who are overweight or obese (BMI Ն25 kg/m 2 ) and who have one or more additional risk factors for diabetes (see Table 4 of the "Standards of Medical Care in Diabetes-2011").In those without these risk factors, testing should begin at age 45 years.(B) • If tests are normal, repeat testing carried out at least at 3-year intervals is reasonable.(E) • To test for diabetes or to assess risk of future diabetes, A1C, FPG, or 2-h 75-g OGTT are appropriate.(B) • In those identified with increased risk for future diabetes, identify and, if ap-propriate, treat other cardiovascular disease (CVD) risk factors.(B)