ADA supports A1C for diabetes diagnosis

The A1C test is now a recommended method of diagnosing diabetes, according to new clinical practice recommendations from the American Diabetes Association.

Under the new recommendations, an A1C of 5.7% to 6.4% should be considered prediabetes and an A1C of 6.5% or higher merits a diagnosis of diabetes. Previously, the ADA had recommended fasting plasma glucose and the oral glucose tolerance test as the preferred diagnostic methods. Those methods are still recommended, but ADA experts hope that the addition of the A1C, which does not require fasting, will increase the use of testing, according to a press release. The recommendations were published in a supplement to the January issue of Diabetes Care.

The ADA also recommended that aspirin therapy should be considered as a primary prevention strategy in patients with diabetes who have a 10-year cardiovascular risk greater than 10%. That group will include most men over 50 and women over 60 who have at least one additional major risk factor. Previously, the ADA had suggested low-dose aspirin for patients who were over 40 or had risk factors. However, the new recommendations found insufficient evidence for primary prevention in lower-risk patients. For younger patients with multiple risk factors, clinical judgment about the use of aspirin is required, the recommendations said.

The document includes many additional recommendations for optimizing diabetes care, both in the general population and specific groups such as children and the elderly, and in inpatient and outpatient settings.