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Predicting Risk for Diabetes: Choosing (or Building) the Right Model

William H. Herman, MD, MPH
[+] Article, Author, and Disclosure Information

From University of Michigan, Ann Arbor, MI 48109.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: William H. Herman, MD, MPH, 1500 East Medical Center Drive, 3920 Taubman Center, Box 5354, Ann Arbor, MI 48109; e-mail, wherman@umich.edu.

Ann Intern Med. 2009;150(11):812-814. doi:10.7326/0003-4819-150-11-200906020-00010
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Whether to screen for type 2 diabetes mellitus in asymptomatic adults is controversial (1). No trial has established that systematic screening for diabetes and early treatment improve health outcomes more than treatment after routine clinical diagnosis (2). The U.S. Preventive Services Task Force (USPSTF) recently recommended testing adults for diabetes if they have symptoms of diabetes or evidence of diabetic complications, including vascular disease (2). It also recommended screening adults for diabetes if they have sustained blood pressure greater than 135/80 mm Hg, because lowering blood pressure below conventional target values in patients with diabetes reduces the incidence of cardiovascular events and mortality (2). Although the ongoing ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care) (3) may settle the benefits of screening and early treatment, the USPSTF currently recommends against screening asymptomatic adults for diabetes, largely because evidence of benefit is lacking (2).

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