Diabetes Education and Research Center
Frequently Asked Questions about Diabetes



What are the ADA's recommendations for diagnosing type 2 diabetes?


An Expert Committee of the American Diabetes Association met in 1997. After reviewing 15 years of diabetes research, the ADA recommended substantial changes in the way diabetes was diagnosed and classified.

Diagnosis is still based on measurement of blood glucose, however the 2-hour Oral Glucose Tolerance Test (OGTT) has given way to the simpler Fasting Plasma Glucose (FPG) test as the preferred diagnostic tool. Type 2 diabetes can be diagnosed by the following:

Impaired glucose tolerance (IGT) is the term used to describe blood glucose (BG) levels that are higher than normal but lower than those for diabetes.* A diagnosis of IGT can only be arrived at by testing blood glucose. There are no clinical signs or symptoms which are being used to define this condition.

Other names no longer used for IGT include "borderline," "subclinical," "chemical," and "latent" diabetes.

A diagnosis of IGT does not come without risk. People with IGT have a higher occurrence of cardiovascular disease and are at a higher risk of developing type 2 diabetes than those without IGT. Approximately 25% of people with IGT will develop type 2 diabetes. Complications associated with type 2 diabetes that involve the smaller blood vessels (i.e. those affecting the eyes and kidney) however appear to pose a minimal risk for those with IGT.

The prevalence of IGT in the US adult population, based on national surveys in 1976-80 and 1982-84, was estimated to be 11.2%, ranging from 6.4% at age 20-44 years to 22.8% at age 65-74 years. (Data on diabetes prevalence is more recent. During 1991-93, the prevalence of all types of diagnosed diabetes ranged from 5.8% at age 45-64 years to 10.7% at age 65-74 years.)

The risk factors for IGT appear to be similar to those for type 2 diabetes: a family history of diabetes, higher blood glucose levels, obesity, and a sedentary lifestyle.

* The World Health Organization (WHO) defines IGT as fasting plasma glucose less than 140 mg/dl and, after ingestion of 75 g of glucose, a two-hour BG value of 140-199 mg/dl.


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