From the Guidelines
According to the American Diabetes Association (ADA), screening for diabetes mellitus in asymptomatic adults with no risk factors should begin at age 35. This recommendation is based on the most recent evidence from the ADA standards of care in diabetes-2024 1. The screening typically involves measuring fasting plasma glucose, hemoglobin A1C, or performing an oral glucose tolerance test.
Key Points to Consider
- Starting screening at this age allows for earlier detection of prediabetes or diabetes, which enables timely intervention to prevent or delay complications.
- Individuals with risk factors such as obesity, family history of diabetes, certain racial/ethnic backgrounds, history of gestational diabetes, or hypertension should be screened earlier, regardless of age.
- Early detection is crucial because many individuals with type 2 diabetes may remain asymptomatic for years while vascular and neurological complications develop.
- If tests are normal, repeat screening is recommended at a minimum of 3-year intervals, or sooner with symptoms or change in risk (e.g., weight gain) 1.
Screening Methods
- FPG, 2-h PG during 75-g OGTT, and A1C are each appropriate for screening for prediabetes and type 2 diabetes 1.
- When using OGTT as a screen for prediabetes or diabetes, adequate carbohydrate intake (at least 150 g/day) should be assured for 3 days prior to testing 1.
From the Research
ADA Screening Recommendations
- The American Diabetes Association (ADA) recommends screening for type 2 diabetes annually in patients 45 years and older, or in patients younger than 45 years with major risk factors 2, 3.
- For asymptomatic adults with no risk factors, the ADA screening recommendations should begin at the age of 45 2, 3.
Screening Eligibility and Detection
- The US Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who are overweight or obese, and repeating testing every three years if results are normal 2, 3.
- A cross-sectional study using NHANES data assesses the proportion of asymptomatic US adults eligible for screening based on new vs current US Preventive Services Task Force and American Diabetes Association screening guidelines 4.