Diagnosing the risk of diabetes, pre-diabetes and diabetes

Diagnosing the risk of diabetes, pre-diabetes and diabetes is done by evaluating glycemic values ​​in venous plasma or glycosylated hemoglobin (Hb A1c) values ​​in the blood. A basal glucose value <101 mg/dl is normal, over 126 mg/dl means diabetes and glycemic values ​​between 101-126 mg/dl means risk of diabetes or pre-diabetes and requires an Oral Glucose Tolerance Test (OGTT). Pre-diabetes is characterized by the presence of one of the following three metabolic states preceding diabetes: Impaired Glucose Tolerance (IGT), Impaired Fasting Glucose (IFG) or a combination of these two metabolic states, associated with specific changes in basal glucose and at 2h in OGTT. The diagnosis of diabetes can also be made if the blood glucose value measured at any time of the day, regardless of the last meal, is ≥200 mg/dL (≥11.1 mmol/L), especially if the individual has symptoms of hyperglycemia or hyperglycemic crisis.

The measurement units of blood glucose in which the analysis is done are mg/dL or mmol/L, but not simultaneously in both or the percentage of glycosylated hemoglobin. The risk factors associated with diabetes are only active for blood glucose values ​​between 101 - 108 mg/dl.

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For OGTT, the basal blood glucose (at 0h) and the one at 2h are taken into account. It is recommended that at the time of performing the OGTT the glycosylated hemoglobin should be also done as it can help to diagnose the risk of diabetes or certain pre-diabetic conditions. For OGTT the normal basal blood glucose value is ≤101 mg/dl and at 2h it is <140 mg/dl.


Basal glycemia or Hb A1c, % Glycemia ≤101 mg/dl or Hb A1c <5.5% Glycemia >101 and ≤108 mg/dl or Hb A1c between 5.6 - 5.9% Glycemia >108 and <126 mg/dl or Hb A1c between 6.0 - 6.4% Glycemia ≥126 mg/dl or Hb A1c ≥6.5% Perform an OGTT at 2h, with 75 grams of glucose on empty stomach If there is at least one risk factor No risk factors Basal glycemia ≥126 mg/dl Glycemia at 2h ≥200 mg/dl Basal glycemia btw 109-125 mg/dl Glycemia at 2h btw 140-199 mg/dl Basal glycemia btw 109-125 mg/dl Glycemia at 2h <140 mg/dl Basal glycemia <109 mg/dl Glycemia at 2h btw 140-199 mg/dl Basal glycemia <109 mg/dl Glycemia at 2h <140 mg/dl IFG and IGT IFG IGT Hb A1c 6.0 - 6.4% Hb A1c <6.0% or untested NORMAL RISK OF DIABETES PRE-DIABETES DIABETES Repeat the lab tests to confirm diagnosis