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APPENDIX K: SCREENING AND DIAGNOSIS OF DIABETES MELLITUS
IN PRIMARY CARE SETTINGS

Management of Diabetes Mellitus (DM) in Primary Care Settings

Consider screening for diabetes (Module 2)
1) Age ≥ 45 years old, OR
2) Anyone with risk factors for diabetes, OR
3) Anyone with symptoms or signs of diabetes

Check fasting glucose (FG) or Glycated haemoglobin (HbA1c)

FG < 6.1 FG 6.1–6.9 FG ≥ 7.0
mmol/L mmol/L mmol/L [1]

Consider oral glucose tolerance test (75g) HbA1c
≥ 6.5% [1]

FG < 6.1 mmol/L FG 6.1–6.9 mmol/L & FG < 7 mmol/L & Post
Post < 7.8 mmol/L Post < 7.8 mmol/L Post ≥ 7.8–11.0 mmol/L ≥ 11.1 mmol/L [1]

Impaired Impaired
Diabetes fasting glucose glucose Diabetes
unlikely confirmed
(IFG) tolerance (IGT)

Lifestyle advice (Module 1) Lifestyle modification Management of diabetes in
Retest yearly if high risk primary care settings
Retest 3-yearly if no risk factors Annual review with blood test (turn over to continue)

Risk factors for diabetes (Module 2)
• Age ≥ 45 years old • Metabolic syndrome
• Family history (first-degree relatives) of diabetes • Clinical cardiovascular diseases
• Overweight or obesity (e.g. coronary heart disease, stroke, peripheral
vascular disease)
• Previous impaired glucose tolerance (IFG) or
impaired fasting glucose (IGT) • Presence of other cardiovascular risk factors
• Abdominal circumference: ≥ 80cm in females, • Women with history of gestational diabetes
≥ 90cm in males or big baby
• Hypertension (HT) (blood pressure (BP) • Polycystic ovarian syndrome
≥ 140/90 mmHg) • Long term systemic steroid therapy

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