DIABETES SCREENING AND DIAGNOSIS

Screening for type 2 diabetes

All individuals should be evaluated annually for type 2 diabetes risk on the basis of demographic and clinical criteria. Screening for diabetes (algorithm, or Figure 1 for flowchart) using an FPG should be performed every 3 years in individuals >40 years of age. More frequent and/or earlier testing with either an FPG or a 2hPG in a 75-g OGTT should be considered in those with additional risk factors.

Risk factors for type 2 diabetes

Age >_40 years

First-degree relative with diabetes

Member of high-risk population (eg. People of Aboriginal,

Hispanic, South Asian, Asian or African descent)

History of IGT or IFG*

Presence of complications associated with diabetes

Vascular disease*

History of GDM

History of delivery of a macrosomic infant

Hypertension*

Dyslipidemia*

Overweight*

Abdominal obesity*

Polycystic ovary syndrome*

Acanthosis nigricans*

Schizophrenia

*associated with the metabolic syndrome

Clinical identification of the metabolic syndrome* using NCEP ATPIII criteria

Risk Factor	Defining Level
FPG	>/= 6.1 mm/L
BP	>/+ 130/85
TG	>/= 1.7 mm/L
HDL-C Men Women	<1.0 mm/L <1.3 mm/L
Abd. Obesity Men Women	Waist Circ. >102 cm. >88 cm.

*A diagnosis of metabolic syndrome is made when 3 or more of the risk determinants are present.

Reference:

Canadian Diabetes Association Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2003;27(suppl 2): S1-S152.