Should we screen for type 2 diabetes: Yes

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e4514 (Published 9 July 2012)
Cite this as: BMJ 2012;345:e4514

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  1. Kamlesh Khunti, professor 1,
  2. Melanie Davies, professor 2
  1. 1Department of Health Sciences, University of Leicester, Leicester Diabetes Centre, Leicester LE5 4PW, UK
  2. 2Department of Cardiovascular Sciences, University of Leicester
  1. Correspondence to K Khunti kk22{at}le.ac.uk

Kamlesh Khunti and Melanie Davies believe that screening for diabetes is feasible and cost effective, but Elizabeth Goyer and colleagues (doi:10.1136/bmj.e4516) think that a population approach to modifying risk factors would be better

Type 2 diabetes is common, increasing in prevalence, and associated with high morbidity, mortality, and healthcare costs. Current estimates suggest that there are about 3.1 million adults in England with diabetes, of whom roughly a quarter are undiagnosed.1 For several years many countries have been debating whether to screen for diabetes.2 The disease certainly meets many of the criteria for screening: its natural course is well characterised, it can be asymptomatic, many people remain undiagnosed, high numbers of people have complications at diagnosis, and there is now good quality evidence regarding effective management for those with established diabetes. There is also evidence that screening for diabetes does not result in any harm to patients.3 4 Although there has been some uncertainty about the uptake of a screening programme in the real world setting,5 we believe it should be implemented.

Evidence for screening

No trials have compared screening for diabetes with no screening, which would be the ideal platform to establish whether screening is cost effective. The recent ADDITION Europe randomised study …

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