Type 2 Diabetes Risk Test (ADA)

Methodology

ADA Diabetes Risk Test (Bang et al., 2009)

Points: age 40–49 = 1, 50–59 = 2, ≥60 = 3; male 1; gestational diabetes 1; family history 1; hypertension 1; inactive 1; BMI 25–29.9 = 1, 30–39.9 = 2, ≥40 = 3. Score ≥5 = increased risk.

The ADA's self-assessment score was developed and validated in US national survey data (NHANES). A score of 5 or more identifies people at increased risk who should discuss blood testing. The 2009 score had no gestational diabetes item because the data were not available; the ADA test adds it (1 point).

Who it is for

Adults aged 18 and over who do not have diagnosed diabetes.

Version

2.0.1

How this calculator works

Where the formula comes from

• Bang and colleagues (2009) developed the score in NHANES 1999–2004 and validated it in NHANES 2005–2006 and a combined ARIC/CHS cohort of US adults aged 20 or over; the target was undiagnosed diabetes (fasting glucose 126 mg/dL or more without known diabetes).^[1]

The inputs

• Age, sex, family history of diabetes, history of hypertension, obesity and physical activity were independently associated with undiagnosed diabetes and form the score.^[1]
• At a score of 5 or more, 35% of people in NHANES and 40% in ARIC/CHS were selected for testing; sensitivity was 79% and 72%, specificity 67% and 62%, and positive predictive value 10% in both.^[1]

Where accuracy falls (published evidence)

• Gestational diabetes was not available in the study data, so it was not part of the 2009 score.^[1]
• The score detects currently undiagnosed diabetes; it was not built to predict future diabetes.^[1]

What guidelines say

• The ADA Standards of Care (2025) list the ADA risk test as an option for deciding whether to test asymptomatic adults; diagnosis requires fasting glucose, a 2-hour OGTT value or HbA1c.^[2]
• ADA screening criteria use a BMI threshold of 23 kg/m² rather than 25 kg/m² for people of Asian ancestry.^[2]

Sources

1. Bang H, Edwards AM, Bomback AS, et al. Development and validation of a patient self-assessment score for diabetes risk. Ann Intern Med. 2009;151(11):775–783. doi:10.7326/0003-4819-151-11-200912010-00005
2. American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S27–S49. doi:10.2337/dc25-S002

Compiled from the published sources above. Every statement was agreed independently by three AI research tools (Claude, ChatGPT, DeepSeek) and its source verified in PubMed or Crossref by the Hakeemly editorial team. Not reviewed by a doctor unless stated. Agreed on 2026-10-12

Worked example: how to calculate diabetes risk (ADA)

An illustration with sample values, worked out with the same method the tool above uses.

Limitations

• A screening questionnaire, not a test for diabetes. Only a blood test (HbA1c, fasting glucose or glucose tolerance test) can diagnose diabetes.
• Validated in US adults; ADA uses a lower BMI threshold (23 kg/m²) for screening people of Asian ancestry.

References

1. Bang H, Edwards AM, Bomback AS, et al. Development and validation of a patient self-assessment score for diabetes risk. Ann Intern Med. 2009;151(11):775–783. doi:10.7326/0003-4819-151-11-200912010-00005
2. American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S27–S49. doi:10.2337/dc25-S002