ADA Diabetes SOC

Which of the following is NOT a diagnostic criterion for diabetes in a nonpregnant adult?

• A1C ≥ 6.5%

• FPG ≥ 126 mg/dL after at least 8 hours fasting

• 2-hour plasma glucose ≥ 200 mg/dL on a 75-g OGTT

• FPG ≥ 110 mg/dL confirmed on two occasions

A 52-year-old man, BMI 31 kg/m², has an A1C of 6.0%. He is concerned about developing type 2 diabetes. According to ADA Standards of Care, what is the most effective intervention?

• Start metformin immediately

• Begin intensive lifestyle program

• Initiate GLP-1 receptor agonist therapy

• Monitor annually without intervention

A 40-year-old woman with BMI 38 kg/m², A1C 6.1%, and history of gestational diabetes asks if she should take medication for prediabetes. Which is the best option?

• No intervention needed; monitor annually

• Lifestyle only; medications not indicated

• Start metformin for diabetes prevention

• Start insulin therapy

According to ADA Standards, what percentage of U.S. adults with diabetes achieve the triple goal of A1C, blood pressure, and LDL at target?

• 75%

• 55%

• 22%

• 40%

A 15-year-old Black male with type 1 diabetes has an average A1C of 9.3%. His provider notes limited family resources and inconsistent insulin use. Which is the best systems-level intervention to improve his outcomes?

• Intensify insulin dosing without other changes

• Refer to a diabetes prevention program

• Engage interprofessional team care, including social and financial support services

• Switch to oral agents for adherence

A 53-year-old Hispanic woman with a BMI of 32 kg/m² presents for a routine visit. Her fasting plasma glucose is 122 mg/dL and A1C is 5.9%. She is asymptomatic.

What is the most appropriate classification?

• Normal glucose tolerance

• Prediabetes

• Diabetes mellitus

• Gestational diabetes

Which of the following conditions requires plasma glucose criteria rather than A1C for diabetes diagnosis?

• Sickle cell disease

• Iron deficiency anemia

• Hypertension

• Hyperlipidemia

A 48-year-old man with BMI 36 kg/m² and A1C 6.1% asks about preventing type 2 diabetes. He has a history of gestational diabetes in his spouse.

Which is the most effective first-line recommendation?

• Metformin therapy

• Intensive lifestyle intervention

• Start GLP-1 receptor agonist

• Annual monitoring only

Which dietary patterns have demonstrated benefit in preventing type 2 diabetes?

• Mediterranean diet

• Intermittent fasting

• Low-carbohydrate eating

• All of these

A 67-year-old man with type 2 diabetes, CAD, and CKD presents with an A1C of 6.9%. He is on basal insulin and metformin. He reports frequent nocturnal hypoglycemia.

Which is the most appropriate glycemic goal for this patient?

• A1C <6.0%

• A1C <6.5% regardless of comorbidities

• Individualized; less stringent goal such as <8%

• No A1C monitoring needed