Adapted ADA recommendations for the diagnosis of prediabetes and diabetes³⁴

The current ADA guideline does not include hypogonadism as a risk factor for diabetes. We recommend treating all men receiving ADT as high risk individuals based on recent data about the effect of ADT on insulin sensitivity and its association with diabetes. Consider testing in all asymptomatic adults If testing is normal, repeat yearly while receiving ADT and at least every 3 years otherwise Appropriate tests: FPG or 2-hr OGTT (75 gm glucose load) FPG is the preferred test The use of hemoglobin A1C for the diagnosis of diabetes is not recommended Diagnosis of prediabetes (either of the following): IFG = FPG 100–125 mg/dl IGT = 2-hr plasma glucose 140–199 mg/dl (on OGTT) Criteria for the diagnosis of diabetes (any 1 of the following): FPG 126 mg/dl or greater (fasting defined as no caloric intake for 8 or more hours) Symptoms of hyperglycemia (polyuria, polydipsia, unexplained weight loss) with a casual plasma glucose of 200 mg/dl or greater 2-Hr plasma glucose greater than 200 mg/dl during an OGTT (75 gm glucose) An OGTT may be considered in patients with IFG to better define the risk of diabetes In those identified with prediabetes identify and, if appropriate, treat other cardiovascular disease risk factors