One third of the 20 million Americans who have
diabetes don’t even know it. Another 40 million have been tested and learned they have prediabetes. Recognizing prediabetes lets you take steps to stop or slow the development of type 2 diabetes,
heart disease, and
stroke. Diabetes, the sixth leading cause of death in the United States has become an even more alarming problem because it is occurring more often at a younger age. Overweight, obesity, and physical inactivity, all contributing factors, have also become national health problems.
Diabetes leads to expensive complications and serious disabilities, including damage to the eyes, kidneys, nerves, and heart. Early detection of problems gives you the chance to make changes and take medicine that can help prevent type 2 diabetes from developing.
Many of the current guidelines advise a selective, rather than universal, approach to screening for diabetes mellitus. Note the wording in the recommendations of the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK). 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 of age or older should consider getting tested for diabetes.
- If you are at least 45 years old and overweight, it is strongly recommended that you get tested by your health care provider.
- If you are younger than 45, overweight, and have one or more risk factors (listed below), you should consider testing.
In addition, the U.S. Preventive Services Task Force (USPSTF) published updated recommendations in 2008 in favor of screening adults who have a blood pressure reading of greater than 135/80 mm Hg. The USPSTF, however, does not recommend screening of asymptomatic adults with blood pressure below that threshold due to the lack of evidence to assess the balance of benefits and harms.
A fasting plasma glucose (FPG) test or a 2-hour oral glucose tolerance test (OGTT) can be used to screen for diabetes.
The American Diabetes Association suggests how often to repeat the test:
- All adults 45 years of age 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. If you have prediabetes, have your blood glucose checked again in 1 to 2 years, advises the NIDDK.
- In those who are overweight, testing should begin at an earlier age if additional risk factors are present and be repeated sooner.
Know your risk factors
The American College of Endocrinology and the American Association of Clinical Endocrinologists jointly recommend that you get tested for diabetes starting at 30 years old if you are in a high-risk group due to any of the following:
Your family:
- Your sister, brother, or parent has or had diabetes.
- You are of Latino/Hispanic, African, Asian, Native American, Native Alaskan, or Pacific Island descent.
Your health:
- You are overweight or have a sedentary lifestyle.
- You have hypertension, cholesterol levels (triglycerides or high-density lipoproteins) of concern, heart or vascular disease, or a severe psychiatric illness.
- Prior tests showed you had impaired glucose tolerance or impaired fasting glucose.
Women’s health issues:
Links
NIDDK: Am I at Risk for Type 2 Diabetes?
NHLBI: Calculate Your Body Mass Index
To sign up for a personal diabetes test scheduling reminder,
click here.
Sources
ACE/AACE Diabetes Road Map Task Force. Road maps to achieve glycemic
control in type 2 diabetes mellitus. May/Jun 2007. Endocr Pract
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American Diabetes Association. Standards of medical care in
diabetes—2008 (position statement). Jan 2008. Diabetes Care 31:S12-S54
Available on the Internet through http://www.care.diabetesjournals.org. Accessed 18 Feb 2008.
National
Institute of Diabetes and Digestive Kidney Diseases, National
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U.S. Preventive Services Task Force. Screening for type 2 diabetes
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National Institute for Diabetes and Digestive Kidney Diseases, National Institutes of Health. Am I at risk for type 2 diabetes? (NIH pub. 04-4805). Apr 2004. Available on the Internet at http://www.diabetes.niddk.nih.gov/dm/pubs/riskfortype2/index.htm#4 through http://www.diabetes.niddk.nih.gov. Accessed 19 Jul 2004; revision of Dec 2006 accessed 15 Feb 2008.
American Diabetes Association. Screening for type 2 diabetes. Jan 2004. Diabetes Care 27:S11-14. Brief summary available on the Internet through http://www.guideline.gov. Accessed 19 Jul 2004.
National Center for Chronic Disease Prevention and Health Promotion, Diabetes Public Health Resource, US Centers for Disease Control and Prevention. CDC statements on diabetes issues: screening for type 2 diabetes. 18 Jun 2004. Available on the Internet at http://www.cdc.gov/diabetes/news/docs/screening.htm through http://www.cdc.gov. Accessed 19 Jul 2004 and 15 Feb 2008.
Matfin G and Guven S. Diagnosing Diabetes Mellitus: do we need new criteria? Available on the Internet, from the American Association of Clinical Endocrinologists, at http://www.aace.com/clin/fcc/fcc-200001.php through http://www.aace.com. Accessed 19 Jul 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, ed. American Association of Diabetes Educators. 2003; page 3.
US Preventive Services Task Force. Screening for Diabetes Mellitus, adult type 2. Feb 2003. Available on the Internet at http://www.ahrq.gov/clinic/uspstf/uspsdiab.htm through http://www.ahrq.gov. Accessed 19 Jul 2004 and 15 Feb 2008.
Sherwin RS, et al. Prevention or delay of type 2 diabetes. Jan 2004. Diabetes Care 27:S47-S54. Available on the Internet through http://care.diabetesjournals.org. Accessed 19 Jul 2004 from the National Guideline Clearinghouse and 15 Feb 2008.
