New Screening Could Catch All New Diabetes Cases
posted 08/28/03
Current diabetes screening guidelines are effective, and if followed, could catch virtually all new cases, study findings indicate.

Given that about one third of diabetes cases go undiagnosed, two researchers from the University of Texas Medical Branch in Galveston wondered whether screening guidelines, adopted by several medical societies, are adequate to catch new cases of diabetes.

The guidelines recommend that people without any symptoms should be screened for diabetes every 3 years starting at age 45. In people with risk factors, screening could be more frequent and begin earlier.

Drs. Florence J. Dallo and Susan C. Weller evaluated the performance of the guidelines using the National Health and Nutritional Examination Survey (NHANES III), in which 6,241 individuals are classified as nondiabetic and 274 as having undiagnosed diabetes.

They found that screening all adults who have at least one risk factor for diabetes would catch nearly 100 percent of new cases of diabetes but would require that 83 percent of the adult population be screened.

Screening when two risk factors are present is "more efficient," they say, identifying 98 percent of cases of diabetes by screening only 59 percent of the adult population. "This additional 24 percent reduction in testing could have a large impact on the cost of testing in the United States," they write.

The fact that one third of diabetics continue to go unnoticed suggest that the guidelines are not being followed, the authors note in the Proceedings of the National Academy of Sciences.
Another "notable" finding, according to the team, is that minorities often develop diabetes before age 45, the currently recommended age to begin screening. This 45-year cutoff may need to be reconsidered.

"Very simple rules like testing everyone 45 years of age and older may not be the best rule to follow because that would miss almost half of the minority patients," she said. "A better simple rule is to remember to test whites that are 40 and older and minorities that are 30 and older."

Source: Diabetes In Control Dot Com: Proceeding of the National Academy of Sciences, August 18, 2003. 10.1073/pnas.1733839100.

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