EPG Diabetes Knowledge Centre
Treatment Overview
Screening & Diagnosis
These recommendations are presented in abbreviated form. Readers should refer to the text of the guideline document for a detailed discussion of each of the following topics.
Recommendations
- Each health service should decide whether to have a programme to detect people with undiagnosed diabetes.
- This decision should be based on the prevalence of undiagnosed diabetes and on the resources available to conduct the detection programme and treat those who are detected.
- Universal screening for undiagnosed diabetes is not recommended.
- Detection programmes should target high-risk people identified by assessment of risk factors.
- Detection programmes should use measurement of plasma glucose, preferably fasting.
- For diagnosis, an oral glucose tolerance test (OGTT) should be performed in people with a fasting plasma glucose ≥5.6 mmol/l (≥100 mg/dl) and <7.0 mmol/l (<126 mg/dl).
- Where a random plasma glucose level ≥5.6 mmol/l (≥100 mg/dl) and <11.1 mmol/l (<200 mg/dl) is detected on opportunistic screening, it should be repeated fasting, or an OGTT performed.
- The WHO 1999 criteria1 should be used to diagnose diabetes; these include the importance of not diagnosing diabetes on the basis of a single laboratory measurement in the absence of symptoms.
- People with screen-detected diabetes should be offered treatment and care.
References:
1. World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. Geneva: WHO Department of Noncommunicable Disease Surveillance, 1999: 1-59. http://www.who.int/