1. Test­ing should be con­sid­ered in over­weight or obese (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Amer­i­cans) adults who have one or more of the fol­low­ing risk fac­tors:

First-‍de­gree rel­a­tive with di­a­betes

High-‍risk race/eth­nicity (e.g., African Amer­i­can, Lati­no, Na­tive Amer­i­can, Asian Amer­i­can, Pa­cif­ic Is­lander)

His­to­ry of CVD

Hy­per­ten­sion (≥140/90 mmHg or on ther­a­py for hy­per­ten­sion)

HDL choles­terol level <35 mg/dL (0.90 mmol/‍L) and/‍or a triglyc­eride level >250 mg/dL (2.82 mmol/‍L)

Women with polycys­tic ovary syn­drome

Phys­i­cal in­ac­tiv­i­ty

Other clin­i­cal con­di­tions as­so­ci­at­ed with in­sulin re­sis­tance (e.g., se­vere obe­si­ty, acan­tho­sis ni­gri­cans)

2. Pa­tients with predi­a­betes (A1C ≥5.7% [39 mmol/‍mol], IGT, or IFG) should be test­ed yearly.

3. Women who were di­ag­nosed with GDM should have life­long test­ing at least every 3 years.

4. For all other pa­tients, test­ing should begin at age 45 years.

5. If re­sults are nor­mal, test­ing should be re­peated at a min­i­mum of 3-year in­ter­vals, with con­sid­er­a­tion of more fre­quent test­ing de­pend­ing on ini­tial re­sults and risk category.