Diagnostic criteria for T2DM (HbA1c, fasting glucose, OGTT)?

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 10 December 2025Updated: 10 December 2025 Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Diagnostic criteria for type 2 diabetes mellitus based on HbA1c, fasting blood glucose, and oral glucose tolerance test (OGTT) results are as follows:

  • HbA1c level of 6.5% (48 mmol/mol) or above indicates a diagnosis of type 2 diabetes in adults who are not pregnant.
  • Fasting venous plasma glucose concentration of 7.0 mmol/l or greater is diagnostic of type 2 diabetes.
  • Two-hour venous plasma glucose concentration of 11.1 mmol/l or greater after a 75 g anhydrous glucose load in an OGTT confirms the diagnosis.
  • Alternatively, a random venous plasma glucose concentration of 11.1 mmol/l or greater in the presence of symptoms can also be diagnostic.
  • In asymptomatic patients, the diagnosis should be confirmed by repeating the test using World Health Organization criteria.

These criteria apply to adults who are not pregnant and are based on NICE guidelines and WHO recommendations.

Educational content only. Always verify information and use clinical judgement.