Millions of Americans unknowingly have diabetes or prediabetes. Early identification through a reliable and convenient screening test can lead to prompt identification, intervention, and improved health outcomes. Fasting blood glucose measured through a chemistry panel is inconvenient, highly variable, and delays care, unlike HbA1c point-of-care (POC) tests. This prospective longitudinal study compares diabetes screenings between standard practices vs systematically offered point-of-care (POC) hemoglobin A1c (HbA1c) tests in patients age 45 years or older. Systematically screened participants (n = 164) identified 63% (n = 104) with unknown hyperglycemia and 53% (n = 88) in prediabetes. The standard practice (n = 324) screened 22% (n = 73), most commonly by blood glucose (96%); 8% (n = 6) and 33% (n = 24) were found to have diabetes and prediabetes, respectively. The association between screening outcome and screening method was statistically significant (P = 0.005) in favor of HbA1c.. HbA1c may be the most effective method to identify patients unknowingly living in hyperglycemia. Point-of-care tests further facilitate screening evaluation in a timely and feasible fashion. — Ann Fam Med. 2017 Mar;15(2):162-164. doi: 10.1370/afm.2035. ONUDL 28289117