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Diagnosis of Type 2 Diabetes 1
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Glucose Testing and Interpretation: AACE Diagnostic Criteria TestResultDiagnosis FPG, mg/dL (measured after 8-hour fast) ≤99Normal 100-125Impaired fasting glucose ≥126 Diabetes Confirmed by repeat testing on a different day PPG, mg/dL (measured with an OGTT performed 2 hours after 75-g oral glucose load taken after 8-hour fast) ≤139Normal 140-199Impaired glucose tolerance ≥200 Diabetes Confirmed by repeat testing on a different day Random plasma glucose, mg/dL With polyurea, polydipsia, or polyphagia ≥200Diabetes Hemoglobin A1C, % (screening only) ≤5.4Normal 5.5-6.4High risk/prediabetes ≥6.5 Diabetes 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. 2
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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 3
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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. 4
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Glucose Testing and Interpretation: ADA Diagnostic Criteria TestResultDiagnosis Hemoglobin A1C, % ≤5.6Normal 5.7-6.4High risk/prediabetes ≥6.5 Diabetes Confirmed by repeat testing in absence of unequivocal hyperglycemia FPG, mg/dL (measured after 8-hour fast) ≤99Normal 100-125Impaired fasting glucose ≥126 Diabetes 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) ≤139Normal 140-199Impaired glucose tolerance ≥200 Diabetes Confirmed by repeat testing in absence of unequivocal hyperglycemia Random plasma glucose, mg/dL, with polyurea, polydipsia, or polyphagia ≥200Diabetes FPG, fasting plasma glucose; OGTT, oral glucose tolerance test; PPG, postprandial glucose. ADA. Diabetes Care. 2013;36(suppl 1):S11-S66. 5
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