US Department of Health and Human Services Diabetes Detection Initiative: Finding the Undiagnosed photos of people
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Health Care Providers

The "Diabetes Detection Initiative: Finding the Undiagnosed" is a diabetes detection program that utilizes health education/communication and community health interventions to increase the number of at-risk individuals that undergo a risk assessment and if appropriate, receive blood testing to determine if they have diabetes and necessary follow-up. Appropriate information about risk reduction will also be given to individuals who are identified with pre-diabetes or considered to be high-risk.

Scientific and clinical studies have demonstrated that if diabetes is well managed, the potentially devastating complications of this disease can be prevented or delayed. However, diabetes must first be diagnosed to be effectively treated and managed. Thus it is critically important to identify the millions of people with unrecognized diabetes earlier in the course of the disease so that they can benefit from earlier interventions to reduce both the microvascular and macrovascular diseases that can occur from diabetes. This early identification has the potential to reduce morbidity and mortality, improve quality of life, and lower the financial costs to individuals and society that result from diabetes complications.

Risk Assessment - Information for Health Providers: Steps to Finding the Undiagnosed
Desktop Guide* (PDF, 40KB)
Pocket Guide* (PDF, 40KB)

Assessing Risk

Step One: Patients will have taken a paper and pencil risk test. (Adapted from Diabetes Care 1995; 18:382-7 and the American Diabetes Association

Step Two: Determine if the need for additional testing for diabetes is appropriate. If the self-administered risk test score is ≥10 points, testing for diabetes may be warranted. While a fasting blood glucose is recommended for diagnosis of diabetes, additional information on risk may be provided from non-fasting blood glucose measurements. You may enter the following information on the interactive worksheet to help you determine whether or not an Oral Glucose Tolerance Test or Fasting Plasma Glucose Test to diagnose diabetes is appropriate:

Age (yrs)


BMI (kg/m2)

Random capillary plasma glucose (mg/dl)

Postprandial time since any meal (0-8+ hr)

Interactive Worksheet

Interactive worksheet. (Adapted from Diabetes Care 2002: 25 1999-2003)

Step Three: If the calculator results in a P score of ≥ to 0.20, diagnostic testing is indicated. The criteria for diagnosis are (From Diabetes Care 2003; 26 S5-S20):

A single casual plasma glucose ≥200 mg/dl with unequivocal symptoms of diabetes


In the absence of unequivocal diabetes symptoms:
Fasting plasma glucose ≥ 126 mg/dl or 2-hr 75 gram OGTT ≥ 200 mg/dl

Repeat measure on a different day to confirm diagnosis is necessary.

Information About Diabetes

Links to clinical practice tools, patient education materials and additional diabetes websites. More>

About Pre-diabetes

The National Diabetes Education Program, an initiative of the Steps to a Healthier US program, is pleased to provide you with a Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetes toolkit. The kit includes a "decision pathway" to help you diagnose diabetes, provides information on the respective value of Fasting Plasma Glucose (FPG) and Oral Glucose Tolerance Tests (OGTT) and other background information. Get the Toolkit* (PDF 1MB).

The Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services is pleased to provide you with a primer on Medicare programs that can assist you in reimbursement for blood glucose testing.


Last updated: 08/12/2004

*PDF files require the free Adobe Acrobat Reader application for viewing.

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