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

1. 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.
2. Detection programmes should use measurement of plasma glucose, preferably fasting.
3. 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).
4. 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.
5. 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.
6. 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/