Article Summary Strategies to Identify Adults at High Risk for Type 2 Diabetes. The Diabetes Prevention Program Research Group. Diabetes Care. 2005;28:138-144. Objective: To review data from various screening methods used in the Diabetes Prevention Program (DPP), to determine successful approaches for the development of future diabetes screening programs. Methods: Persons eligible for DPP had both impaired glucose tolerance (IGT) and elevated fasting plasma glucose (EFG). Assessment of criteria was divided into steps. Step 1 included a brief interview and a capillary blood glucose test. In step 2, subjects who were potentially eligible were asked to undergo a 75-gram oral glucose tolerance test (OGTT). Persons with IGT and EFG (95 mg/dL to 125 mg/dL, 2-hour glucose of 140 mg/dL to 199 mg/dL, respectively) met the glycemic criteria for DPP eligibility for high-risk incident diabetes, received a medical examination, and were included in a 3-week run-in phase (Step 3). Two main outcomes were the focus of analyses: the presence of IGT and EFG, and previously undiagnosed type 2 diabetes. If fasting glucose was <80 mg/dL or >140 mg/dL as determined by local results, cooperating clinics were directed not to deliver blood to the Central Biochemistry Laboratory (CBL). Similar directions were given to local clinics if 2-hour glucose was <120 mg/dL or >220 mg/dL. CBL values were predicted using linear regression models; CBL glucose was the dependent variable, local glucose was the independent, with regression analyses used to convert local results into CBL-equivalent results. Data from the 2 groups were then pooled to determine overall OGTT yield. Results: Age and body mass index (BMI) and step 1 glucose were strongly associated with the yield of IGT-EFG and with yield of IGT-EFG or newly discovered diabetes. Subjects >60 years were twice as likely to have IGT-EFG compared with those <40 years. Conclusion: The screening approach developed by the DPP identified people who are at high risk of developing type 2 diabetes and should prove useful in both clinical and public health settings as a means of developing primary prevention programs.