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Screening Adults for Type 2 Diabetes Mellitus: Recommendations from the U.S. Preventive Services Task Force FREE

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The summary below is from the full reports titled “Screening for Type 2 Diabetes Mellitus in Adults: Recommendations and Rationale” and “Screening Adults for Type 2 Diabetes: A Review of the Evidence for the U.S. Preventive Services Task Force.” They are in the 4 February 2003 issue of Annals of Internal Medicine (volume 138, pages 212-214 and pages 215-229). The first article was written by the U.S. Preventive Services Task Force; the second report was written by R Harris, K Donahue, SS Rathore, P Frame, SH Woolf, and KN Lohr.


Ann Intern Med. 2003;138(3):I-52. doi:10.7326/0003-4819-138-3-200302040-00005
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What is the U.S. Preventive Services Task Force?

The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that reviews published research and makes recommendations about preventive health care.

What is the problem and what is known about it so far?

Diabetes mellitus is a common disease that interferes with the body's ability to store energy from food. The pancreas makes a substance called insulin that helps to store energy from food. Type 1 diabetes (juvenile diabetes) occurs when the pancreas stops making insulin. In type 2 diabetes (adult-onset diabetes), the body makes plenty of insulin but is unable to use it normally. In both cases, the result is high blood sugar levels. Over time, high blood sugar levels can lead to blindness, kidney failure, nerve damage, and heart disease. Fortunately, good care with diet, exercise, and medications can prevent the development of complications. Good care includes treatment to keep blood sugar levels normal. People with diabetes have more heart attacks and strokes than people without diabetes. Controlling blood pressure and cholesterol helps to prevent these complications. For people with diabetes who also have high blood pressure and cholesterol problems, good care also includes intensive treatment of these conditions. Type 1 diabetes usually does not go long before being diagnosed. However, many people with type 2 diabetes have diabetes for years before symptoms begin. Testing people who have no symptoms to try to detect disease early is called screening. Screening for diabetes would be helpful only if people who begin treatment before symptoms develop do better than people who start treatment after symptoms develop.

How did the USPSTF develop these recommendations?

The USPSTF reviewed published research to measure the benefits and harms of testing for diabetes in people with no symptoms.

What did the USPSTF find?

The USPSTF did not find studies that prove that treating people to lower blood sugar before they have symptoms (increased thirst and urination) would be helpful. More study is needed about this issue. However, the USPSTF did find studies that show that people with high blood pressure or problems with cholesterol would do better if they began treatment before diabetes symptoms developed, especially because they could start intensive blood pressure and cholesterol treatment. Until better studies are available, the USPSTF recommends neither for nor against diabetes screening for patients with normal blood pressure and cholesterol. The USPSTF does recommend that doctors screen patients with high blood pressure or cholesterol problems for diabetes.

What does the USPSTF suggest that patients do?

Patients without high blood pressure or problems with cholesterol should know that it is unclear whether screening for diabetes would help them. Patients should discuss diabetes screening with their doctors.

Patients who have high blood pressure or problems with cholesterol levels should ask their doctors to test them for diabetes.

Patients who have diabetes symptoms (thirst and frequent urination) should report these symptoms to their doctors.

What are the cautions related to these recommendations?

The recommendations may change as new studies become available.

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