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ADA recommends the A1C test for diabetes screening and diagnosis

September 18, 2015

In the current Revisions to the Standards of Medical Care in Diabetes, the section on Diagnosis of Diabetes has been revised to include the use of A1C to diagnose diabetes, with a cut-point of 6.5 percent or greater.

The section previously titled Diagnosis of Pre-diabetes has been renamed Categories of Increased Risk for Diabetes. An A1C range of 5.7-6.4 percent has been included as a category of increased risk for future diabetes.

"So, if you're over the age of 45, or if you're under the age of 45 and overweight and have any other risk factor for diabetes, the recommendation is that you be screened for diabetes to detect early cases," Buse said.

For people with A1C scores in the pre-diabetes range, "diet and exercise aimed at a 5-10 percent reduction of weight, with 30 minutes of moderately vigorous physical activity per day reduces your risk of developing diabetes by 60 percent," Buse said.

The UNC physician points out that for those whose A1C is 6.5% or higher, another test result at or above 6.5 percent is needed to make the diagnosis of diabetes technically official.

"If a patient has an A1C over 6.5, I say 'good news-bad news'. The bad news is that you probably have diabetes. The good news is, technically, we have to measure this test again to make the diagnosis. With a solid effort on lifestyle management, you have a good chance to make your A1C less than 6.5, thereby eliminating having the diagnosis of diabetes."

Buse notes this could provide substantial motivation for patients to make lifestyle changes to lower their A1C score. But he emphasized that people "must remain aware that they're still at high risk for developing diabetes."

Source American Diabetes Association