Who Should Receive Diabetes/Prediabetes Screening?
SOURCE: Laiteerapong N, Cifu AS. Screening for prediabetes and type 2 diabetes mellitus. JAMA 2016;315:697-698.
In October 2015, the United States Preventive Services Task Force (USPSTF) published its first update on screening for diabetes/prediabetes since 2008. Its recommendations apply to overweight or obese adults 40-70 years of age, although the group also endorsed consideration of extending the reach of the screening umbrella to include younger patients or patients with lower body mass index for those with a family history of diabetes, gestational diabetes, polycystic ovary syndrome, or ethnic/racial minorities. The USPSTF recommended screening every three years, using any one or more of A1c, fasting glucose level, or glucose tolerance test.
Although treating persons with prediabetes (using diet, exercise, medication, or combined treatments) delays progression to diabetes, it remains to be seen whether such early identification actually reduces clinical events. Clinical trial outcomes have found no significant reduction in mortality when diabetes-screened populations were compared with unscreened subjects.
With modest differences, the USPSTF recommendations are similar to those of the American Diabetes Association and the American Association of Clinical Endocrinologists. The USPSTF recommendation received a “B” rating, as, “There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.”
Although treating patients with prediabetes delays progression to diabetes, it remains to be seen whether such early identification actually reduces clinical events.
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