Funded out Association’s general revenues and does not use industry support. Funded out Association’s general revenues and does not use industry support

Age of initiation 10 years or at onset of puberty

Frequency: every 3 years

Test with FPG, OGTT, or A1C

Test for undiagnosed T2DM at the 1st prenatal visit in those with risk factors. B

• Test for undiagnosed T2DM at the 1st prenatal visit in those with risk factors. B

• Test for GDM at 24–28 weeks of gestation in women not previously known to have diabetes. A

• Screen women with GDM for persistent diabetes at 4–12 weeks postpartum, using the OGTT. E

Women with GDM history should have lifelong screening for development of diabetes or prediabetes at least every 3 years. B

• Women with GDM history should have lifelong screening for development of diabetes or prediabetes at least every 3 years. B

• Women with GDM history found to have prediabetes should receive lifestyle interventions or metformin to prevent diabetes. A

At 24-28 weeks gestation in women not previously dx’d with overt diabetes

• At 24-28 weeks gestation in women not previously dx’d with overt diabetes

• 75-g OGTT; Measure plasma glucose at fasting and at 1 and 2 hours.

• GDM dx’d when plasma glucose exceeds:

• Fasting: 92 mg/dL (5.1 mmol/L)
• 1 h: 180 mg/dL (10.0 mmol/L)
• 2 h: 153 mg/dL (8.5 mmol/L)

Step 1:

• Step 1:

• In women not previously dx’d with overt diabetes, perform 50-g GLT (nonfasting); Measure plasma glucose at 1 hour.

• If 1 hour plasma glucose level is ≥140 mg/dL* (7.8 mmol/L), proceed to step 2.

All children diagnosed with diabetes in the first 6 months of life should have genetic testing for neonatal diabetes. A

• All children diagnosed with diabetes in the first 6 months of life should have genetic testing for neonatal diabetes. A

• Children and adults, diagnosed in early adulthood, who have diabetes not characteristic of T1D or T2D that occurs in successive generations should have genetic testing for MODY. A

• In both instances, consultation with a center specializing in diabetes genetics is recommended. E

Annual screening for CFRD with OGTT should begin by age 10 years in all patients with cystic fibrosis not previously diagnosed with CFRD. B

• Annual screening for CFRD with OGTT should begin by age 10 years in all patients with cystic fibrosis not previously diagnosed with CFRD. B

• A1C is not recommended as a screening test for CFRD. B

Patients with CFRD should be treated with insulin to attain individualized glycemic goals. A

• Patients with CFRD should be treated with insulin to attain individualized glycemic goals. A

• Annual monitoring for complications of diabetes is recommended, starting 5 years after CFRD diagnosis. E

• See also: “Clinical Care Guidelines for Cystic Fibrosis–Related Diabetes” at Care.Diabetes.org.

A patient-centered communication style that uses active listening, elicits patient preferences, and assesses literacy, numeracy, and potential barriers to care should be used to optimize patient health outcomes and health-related quality of life. B

• A patient-centered communication style that uses active listening, elicits patient preferences, and assesses literacy, numeracy, and potential barriers to care should be used to optimize patient health outcomes and health-related quality of life. B

A complete medical evaluation should be performed at the initial visit to:

• A complete medical evaluation should be performed at the initial visit to:

• Confirm & classify diagnosis B

• Detect complications & potential comorbid conditions E

• Review prior treatment & risk factor control E

• Begin formulation of care management plan B

• Develop a continuing care plan B

Medical history:

• Medical history:

• Age and characteristics of onset of diabetes

• Eating patterns, nutritional status, weight history, sleep behaviors, physical activity habits, nutrition education

• Presence of common comorbidities and dental disease

• Screen for psychosocial problems and other barriers to self-management

• History of tobacco use, alcohol consumption, and substance use

Medical History (2):

• Medical History (2):

• Diabetes education, self-management, and support history & needs

• Previous treatment regimens and response to therapy (A1C records)

• Results of glucose monitoring and patient’s use of data

• DKA frequency, severity, and cause

• Hypoglycemia episodes, awareness, frequency & causes

• Assess medication-taking behaviors/barriers to adherence

Medical History (3):

•