Table 1 Guidelines for diabetes mellitus and lipid screening.

Recommendations of the American Diabetes Association (ADA) [4]

Testing should be considered for those ≥45 years of age and repeated every 3 years, if results are normal.

Testing should be considered younger or more frequently for those who:

   (i) are African-, Hispanic-, Native-, Asian-, or Pacific Island-American

   (ii) are overweight (BMI, kg/m² ≥ 25);

   (iii) have had gestational diabetes or delivered a baby weighing >9 pounds;

   (iv) have a positive family history of diabetes (parents or siblings);

   (v) have hypertension (blood pressure ≥ 140/90 mmHg);

   (vi) have low HDL cholesterol (≤ 35 mg/dl) and/or high triglyceride level (≥ 250 mg/dl);

   (vii) have had impaired glucose (110 ≤ fasting plasma glucose < 126 mg/dl or 140 ≤ oral glucose tolerance test < 200 mg/dl).

Recommendations of the U.S. Preventive Services Task Force (USPSTF) [5]

The USPSTF recommends screening for type 2 diabetes in adults with hypertension or hyperlipidemia.

Lipid screening

Recommendations of the National Cholesterol Education Program (ATP III) [6]

In adults ≥20 years of age, a fasting lipoprotein profile (total cholesterol, LDL and HDL cholesterol) is recommended every 5 years. More frequent measurements are recommended for persons with multiple risk factors or, in those with 0–1 risk factor, if the LDL level is only slightly below the goal level. If the testing opportunity is non-fasting, only the values for total and HDL cholesterol will be usable. In such a case, if total cholesterol ≥200 mg/dL or HDL < 40 mg/dL, a follow-up lipoprotein profile is needed for appropriate management based on LDL.

Recommendations of the U.S. Preventive Services Task Force (USPSTF) [7]

The USPSTF recommends that clinicians screen men aged ≥35 years and women aged ≥45 years and younger adults (men 20–35 and women 20–45 years) if they have other risk factors for coronary heart disease (diabetes, a family history of cardiovascular disease before age 50 years in male relatives or age 60 years in female relatives, a family history suggestive of familial hyper-lipidemia, multiple coronary heart disease risk factors [e.g. tobacco use, hypertension]). The USPSTF recommends that screening for lipid disorders include measurement of total cholesterol and HDL-cholesterol measured on non-fasting or fasting samples. The optimal interval for screening is uncertain. On the basis of other guidelines and expert opinion, reasonable options include every 5 years, shorter intervals for people who have lipid levels close to warranting therapy, and longer intervals for low-risk people who have had low or repeatedly normal lipid levels.