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The U.S. Preventive Services Task Force has announced their new guidelines for prediabetes and type 2 diabetes screening.
The task force recommends that clinicians screen all nonpregnant adults between the ages of 35 and 70 who don’t have symptoms of diabetes but have excess weight or obesity. Overweight is defined as a body mass index (BMI) greater than 25 and obesity is classified as a BMI greater than 30. If the diabetes screening results are found to be normal, most people can rescreen every 3 years.
In the task force’s last recommendation in 2015, screening was recommended for adults beginning at age 40. However, a review of the evidence suggested that the frequency of adults with type 2 diabetes increases at age 35 compared to those of younger ages.
The updated recommendation also comes in light of new evidence demonstrating the positive impacts of early detection. If prediabetes is found in the screening, medications and lifestyle interventions such as changes in diet and increased exercise can delay or prevent the progression of diabetes.
Diabetes is a serious health issue that 13% of all U.S. adults have. As many as 21.4% of adults with diabetes were unaware they had the disease until they had laboratory testing. Additionally, 34.5% of U.S. adults have prediabetes, or the condition of above-normal blood sugar levels that aren’t yet high enough to be classified as type 2 diabetes.
Besides age, risk factors for type 2 diabetes include:
- Prediabetes
- Excess weight or obesity
- A family history of type 2 diabetes
- A lack of physical activity at least 3 days a week
- Having gestational diabetes during pregnancy
- Having fatty liver disease
Certain racial and ethnic groups are at greater risk for type 2 diabetes, including African Americans, Hispanic and Latino Americans, American Indians and Alaskan Natives.
If left unmanaged, diabetes can lead to a number of health complications, such as:
- Chronic kidney disease
- Heart disease
- Hearing loss
- Vision loss
- Nerve damage, such as in the legs, feet, arms, and hands
- Gum disease, cavities, and tooth decay
Other health organizations have different recommendations from the U.S. Preventive Services Task Force. Both the American Diabetes Association and the American Association of Clinical Endocrinologists recommend that any person with risk factors should be tested regardless of age. The groups also recommend that all adults over 45 should be tested for diabetes, regardless of risk factors.
Detection of prediabetes and type 2 diabetes can be done with one of a few tests:
- In a fasting plasma glucose test, your blood sugar will be measured after a night of not eating (fasting).
- A hemoglobin A1C test measures your average blood sugar level over the past 2 to 3 months.
- An oral glucose tolerance test measures the amount of sugar in the blood after drinking a liquid with glucose.
Prediabetes and type 2 type diabetes can be managed with a number of lifestyle changes. Experts recommend:
- Losing weight or maintaining a healthy weight
- Keeping physically active and regularly doing moderate-intensity activities
- Managing glucose levels
- Eating a healthy diet of fruits, vegetables, and healthy fats and less salty and sugary foods
Some people with prediabetes or type 2 diabetes may also need to manage their condition with medications. For example, metformin is a diabetes-management drug that has also been shown to prevent or delay diabetes progressions and help with weight loss. However, metformin has not been approved by the U.S. Food and Drug Administration for preventative purposes.
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