Criteria for the Diagnosis of Diabetes

Fasting Plasma Glucose (FGP) The established glucose criteria for the diagnosis of diabetes (FPG and 2-hour plasma glucose [next slide]) remain valid as well1 Just as there is less than 100% concordance between the FPG and 2-h PG tests, there is no perfect concordance between A1C and either glucose-based test1 Analyses of National Health and Nutrition Examination Survey (NHANES) data indicate that, assuming universal screening of the undiagnosed, the A1C cut point of ≥6.5% identifies one-third fewer cases of undiagnosed diabetes than a fasting glucose cut point of ≥126 mg/dL (7.0 mmol/L)2 However, in practice, a large portion of the diabetic population remains unaware of their condition1 Thus, the lower sensitivity of A1C at the designated cut point may well be offset by the test’s greater practicality, and wider application of a more convenient test (A1C) may actually increase the number of diagnoses made18References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S12-S13; Table 2. Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and high risk for diabetes using A1C criteria in the U.S. population in 1988-2006. Diabetes Care 2010;33:562-568.