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Screening for Diabetes: Can We Afford Not To Screen?

David M. Nathan, MD; and William H. Herman, MD, MPH
[+] Article, Author, and Disclosure Information

From Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114; and University of Michigan, Ann Arbor, MI 48109.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: David M. Nathan, MD, Massachusetts General Hospital Diabetes Center, 50 Staniford Street, Boston, MA 02114; Dnathan@Partners.org.

Current Author Addresses: Dr. Nathan: Massachusetts General Hospital Diabetes Center, 50 Staniford Street, Boston, MA 02114.

Dr. Herman: Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI 48109.

Ann Intern Med. 2004;140(9):756-758. doi:10.7326/0003-4819-140-9-200405040-00017
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Chronic degenerative diseases represent the major challenge to public health in the 21st century. Having largely conquered epidemic infectious diseases, we face a future in which such diseases as diabetes and cardiovascular disease, and their underlying risk factors, predominate. Chronic degenerative diseases already cause 70% of deaths worldwide (1). Our medical care system has largely been attuned to the diagnosis and care of acute diseases, which generally cause symptoms and therefore do not require screening. On the other hand, the early stages of chronic degenerative diseases and the risk factors that presage these diseases are often clinically silent and would go undetected without screening.

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