Updated Type 2 Diabetes Screening Guidelines

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
September 17, 2021
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Type 2 diabetes has been an epidemic in the U.S. for more than a decade — 13 percent of American adults have diabetes and almost 35 percent are considered prediabetic, according to JAMA. Type 2 diabetes is more common in older adults -- the seventh leading cause of death in the U.S. -- and raises the risk for heart disease, kidney failure, blindness, nonalcoholic liver diseases, falls, urinary incontinence, dementia, depression and hearing loss. 

Early Signs of Diabetes

Despite the seriousness of type 2 diabetes, screenings generally don’t begin until you’re older than 45, overweight or have risk factors for type 2 diabetes such as these reported by Mayo Clinic.

Symptoms to look out for:

  • Increased thirst
  • Frequent urination
  • Increased hunger
  • Unintended weight loss
  • Fatigue
  • Blurred vision
  • Slow-healing sores
  • Frequent infections
  • Numbness or tingling in the hands or feet
  • Areas of darkened skin, usually in the armpits and neck

However, the sooner type 2 diabetes is diagnosed, the better. Earlier intervention and management can lead to better outcomes and less complications. This is why the U.S. Preventive Services Task Force has recommended expanding on their current screenings guidelines to begin checking younger adults without symptoms or risk factors.

Type 2 diabetes usually develops over time. A complex series of environmental, genetic and lifestyle factors contribute to the gradual decline of insulin sensitivity. Screening earlier will help doctors notice if your blood sugar -- and more importantly -- HbA1c is rising over time and take a proactive approach in getting control of your blood sugar, as opposed to being reactive when your HbA1c reaches a prediabetic or diabetic range.

New Screening Recommendations

The new recommendations lower the screening age from 45 to 35 who are overweight or obese as defined by having a BMI higher than 25 but no symptoms of diabetes. The recommendation applies to non-pregnant primary care patients.

Types of Diabetes Screening Tests

Here are the screenings used to detect prediabetes, type 1 and type 2 diabetes. 

  • HbA1c level – a common blood test that measures long-term blood sugar concentration. The test is easy and convenient and doesn’t require fasting.
  • Fasting plasma glucose – a blood test taken after eight hours of fasting to measure blood sugar levels.
  • Oral glucose tolerance test – a test that measures a body’s response to sugar.

If your blood sugar is in prediabetic or diabetic range, your doctor will probably develop a treatment plan for you. And if your blood sugar levels are normal, your next screening will probably be scheduled in three years.

Preventing Diabetes

There are some steps you can take to lower your risk for type 2 diabetes. Here are five tips to lower your diabetes risk from the Mayo Clinic.

  1. Manage your weight. If you have some extra weight on you, lose it. Being overweight raises the risk for type 2 diabetes. Studies suggest that losing just a few pounds can significantly lower your risk. 
  2. Be physically active. Regular exercise and physical activity help control weight, lower blood sugar and increase insulin sensitivity. Talk to your doctor before beginning or changing a workout program.
  3. Add plant-based foods to your diet. Plant-based foods such as fruits, vegetables, legumes and whole grains are good sources of nutrients, which help keep your body healthy, and fiber, which slow the absorption of sugar and lower blood sugar levels.
  4. Eat health fats. Healthy fats found in avocados, fatty fish, nuts and seeds provide satiety, helping you manage your weight. A small daily serving of healthy fats contributes to vascular health, which can be negatively affected by diabetes.
  5. Be wary of fad diets. Although you may be tempted to try weight loss diets such as Paleo and Keto, there is not enough research to understand if these diets contribute to preventing diabetes. If you need help losing weight, talk to your primary care doctor or a registered dietician. 

For more information on the new type 2 diabetes screening guidelines or lowering your risk for type 2 diabetes, please talk to your doctor. Need a doctor? Consider partnering with MDVIP. Find a physician near you and begin your partnership in health »

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About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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