[monkburger]

> Also note that HbA1c tests aren't perfect for diagnosing type 2 diabetes and can > have false positives or false negatives.

When we do workups on pts suspected of diabetes, we use the following criteria.

- Iron deficiency anemia workup to confirm accuracy of HbA1C

- HbA1C ≥6.5%

- FPG ≥126mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least eight hours

- Two-hour plasma glucose ≥200mg/dL (11.1 mmol/L) during an oral glucose tolerance test

- In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200mg/dL (11.1 mmol/L)

I would like to redo the diagnostic criteria to include their BMI.

[AlbertCory]

Excellent. Thanks.

Is an A1C level sufficient, all by itself, sufficient to classify them as "pre-diabetic" or are other symptoms required? Or is that even a thing?

[monkburger]

Usually, yes.

However, some PCPs / endo will order up A1c as well as glucose challenge, depending on certain factors (eg, family history, BMI, symptoms). If I were you, order up the following:

- A1C - 12 hour Fasting blood glucose levels - Two-hour glucose tolerance test: this test will measure blood glucose levels before and after ingestion of 75 g of glucose solution (if the results show blood levels that fall between 140 mg/dL to 199 mg/dL, it is diagnostic of prediabetes. - A random plasma glucose test

Personally, if you have a family history of diabetes/obesity, you should get checked often. Some providers have been writing rx's of GLP-1's to aid in weight loss, which reduces the risk of developing T2DM.