BMJ, doi: 10.1136/bmjusa.01060002, (Published 5 September 2002)

Editorials

The case for screening for type 2 diabetes in selected populations

We should follow the American Diabetes Association guidelines on screening

Education and debate BMJ USA p 309
http://bmj.com/cgi/content/full/322/7292/986

The first 150 words of the full text of this article appear below.

This article originally appeared in BMJ USA

Seven criteria should be considered when screening for a disease in an asymptomatic population.1 These are: a) the disease represents an important health problem that imposes a significant burden on the population; b) the natural history of the disease is understood; c) there is a recognizable preclinical (asymptomatic) stage during which the disease can be diagnosed; d) tests are available that can detect the preclinical stage of the disease and the tests are acceptable and reliable; e) treatment after early detection yields benefits superior to those obtained when treatment is delayed; f) the costs of case finding and treatment are reasonable and are balanced in relation to health expenditures as a whole, and facilities and resources are available to treat newly diagnosed cases; and g) screening will be a systematic ongoing process and not merely an isolated one-time effort.
Selected populations recommended for screening for type 2 diabetes*

1.  Individuals >= 45 years (if normal, repeat at 3-year intervals)

2.  Testing should be considered at a younger age or be carried out more frequently in individuals who: are obese (>= 120% desirable body weight or a BMI >= 27 kg/m2), have a first-degree relative with diabetes, are members of a high-risk ethnic population (eg, African American, Hispanic American, Native American, Asian American, Pacific Islander), have delivered a baby weighing >9 lbs or have been diagnosed with GDM, are hypertensive (>= 140/90 mm Hg), have an HDL cholesterol level >= 35 mg/dl and/or a triglyceride level >= 250 mg/dl on previous testing, had IGT or IFG

BMI = body mass index; GDM = gestational diabetes mellitus; HDL = high density lipoprotein; IGT = impaired glucose tolerance; IFG = impaired fasting glucose

*Adapted from: American Diabetes Association. Screening for diabetes. Diabetes Care 2001;24(Suppl 1):S21-S24.

For type 2 diabetes, the . . . [Full text of this article]


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