Type 2 Diabetes
Type 2 diabetes is occurring at an alarming rate in the U.S. Overweight, obesity, and physical inactivity, all contributing factors, have become national health problems.
America’s medical experts and public health advisors remain cautious about expanding their guidelines on who should be screened for diabetes mellitus. Screening low-risk, symptom-free people throughout the country would be expensive. To support a universal screening recommendation, the experts require more proof that early detection and treatment of diabetes reduces long-term complications. One thing many experts have come to understand is that screening is most beneficial if it is conducted by someone involved in your health care; that is, when the test is done as part of a medical office visit. The amount of glucose in your blood can be measured to diagnose the condition.
Many of the current guidelines lean toward a selective, rather than universal, approach to screening for diabetes. Note the wording in the recommendations of the National Institute for Diabetes and Digestive and Kidney Diseases. It emphasizes who should “consider” getting tested (who should discuss it with their health care provider) and for whom testing is “strongly recommended.”
Anyone 45 years or older should consider getting tested for diabetes.
If you are 45 or older and overweight, it is strongly recommended that you get tested.
If you are younger than 45, overweight, and have one or more of the risk factors*, you should consider testing.
The American Diabetes Association guidelines offer insight into how often to repeat the test:
All adults age 45 years and older should be considered for diabetes screening by their health care provider every 3 years, particularly those with a body mass index greater than 25 kg/m2.
In those who are overweight, testing should begin at an earlier age and be carried out more frequently if additional risk factors* are present.
*Obesity, hypertension, high cholesterol, inactivity, and a family history of diabetes are some of the factors that increase your risk. African Americans, Hispanic Americans, Native Americans, Asian Americans, and Pacific Islanders - all populations with a high rate of the disease - are candidates for early screening.
Although the U.S. Preventive Services Task Force announced that it could not, for its February 2003 recommendation, determine the balance of benefits and harms of routine screening, it does recommend the following:
Adults with hypertension (high blood pressure) or hyperlipidemia (high cholesterol) should be screened for type 2 diabetes.
Information to help you understand your risk and learn how to lower your chances of developing diabetes is available from the National Diabetes Information Clearinghouse at http://www.diabetes.niddk.nih.gov.
A helpful and easy-to-use calculator on adult body mass is available at the web site of the National Heart, Lung, and Blood Institute at http://www.nhlbisupport.com/bmi.
To sign up for a personal diabetes test scheduling reminder, click here.
Sources
American Diabetes Association. Screening for type 2 diabetes. Diabetes Care. 2004 Jan;27(Suppl 1):S11-14. Brief summary from the National Guideline Clearinghouse available on the Internet at http://www.guidelines.gov. Accessed July 19, 2004.
Matfin G and Guven S. Diagnosing Diabetes Mellitus: do we need new criteria? Available on the Internet from the web site of the American Association of Clinical Endocrinologists at http://www.aace.com/clin/fcc/fcc-200001.php. Accessed July 19, 2004.
Mayer-Davis EJ, D’Antonia A, Tudor-Locke C. Lifestyle for diabetes Prevention. In: Diabetes in the Life Cycle and Research: A Core Curriculum for Diabetes Education (5th ed.). Franz MJ, editor. American Association of Diabetes Educators. 2003; page 3.
National Diabetes Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, United States Department of Health and Human Services. Am I at risk for type 2 diabetes? NIH publication no. 04-4805. 2004 Apr. Available on the Internet at http://www.diabetes.niddk.nih.gov/dm/pubs/riskfor type2/index.htm. Accessed July 19, 2004.
Sherwin RS, Anderson RM, Buse JB, et al. Prevention or Delay of Type 2 Diabetes. Diabetes Care. American Diabetes Association. 2004 Jan;27(Suppl 1):S47-54. Available on the Internet from the National Guideline Clearinghouse at http://www.guidelines.gov. Accessed July 19, 2004.
National Center for Chronic Disease Prevention and Health Promotion, Diabetes Public Health Resource, Centers for Disease Control and Prevention, United States Department of Health and Human Services. CDC statements on diabetes issues: screening for type 2 diabetes. 2004 Jun 18. Available on the Internet at http://www.cdc.gov/diabetes/news/doc/screening.htm. Accessed July 19, 2004.
United States Preventive Services Task Force. Screening for Diabetes Mellitus, adult type 2. 2003 Feb. Available on the Internet at http://www.ahrq.gov/clinic/uspstf/uspsdiab.htm. Accessed July 19, 2004.
