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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Since Medicare began covering A1c testing for diabetes screening in January 2024, monthly testing among adults 65+ jumped 30%, and prediabetes/diabetes detection surged from 48.5% to 67.4%. The change is helping catch dysglycemia that fasting glucose tests often miss in older patients. Clinicians say the shift opens the door to earlier interventions — from lifestyle programs to metformin and GLP-1 receptor agonists.
Before 2024, Medicare only covered fasting blood glucose and oral glucose tolerance tests for diabetes screening — leaving A1c, a simpler, no-fasting-required test, off the table. That changed on January 1, 2024, when CMS expanded coverage to include A1c, and new data presented at the ADA 2026 Scientific Sessions show the impact has been substantial.
Researchers analyzed Quest Diagnostics lab data and found that monthly A1c testing volume among adults 65 and older rose 30.1% after the coverage expansion. More striking: the share of those tests flagging prediabetes or diabetes jumped from 48.5% to 67.4% — suggesting A1c is catching dysglycemia that fasting glucose tests routinely miss in older adults.
By the Numbers:
Why it matters: Earlier detection of prediabetes in older adults opens the door to timely interventions — lifestyle coaching through Medicare's Diabetes Prevention Program, metformin, or newer GLP-1 receptor agonists — that can slow or prevent progression to type 2 diabetes. Physicians had been advocating for this coverage change for years, and the data suggest it's already making a measurable difference.
