Who Should be Screened? Using The Canadian Diabetes Risk Questionnaire (CANRISK)

Mr. AW qualifies for screening on a variety of levels:

• High risk based on risk calculator
• Individuals ≥ 40 should be screened every three years

In addition, Mr. AW has the following risk factors:

• Age ≥ 40
• First-degree relative with type 2 diabetes
• Member od high-risk population: Asian
• Overweight
• Abdominal obesity

These factors are used to calculate his CANRISK score. Further investigation would probably reveal additional risk factors.

What tests should be ordered to screen for diabetes?

FPG A1C FPG and A1C

Diabetes Canada’s Guidelines suggest screening with a FPG and/or A1C. In this case, a FPG and A1C is ordered.

Screening tests for type 2 diabetes reveal the following results:

• FPG: 5.8 mmol/L
• A1C: 6.3%

What would be the next steps?

Repeat both tests (FPG and the A1C)
Repeat the “higher” test
Initiate healthy behaviour interventions

Initiate healthy behaviour interventions.

Mr AW has prediabetes and repeat testing is not required. An OGTT can be considered, but is not mandatory. Healthy behaviour interventions and or dietary patterns shown to reduce the risk of type 2 diabetes should be instituted (see chapter "Reducing the risk of developing diabetes") and FPG and/or A1C should be repeated in 3-6 months.