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.
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.