Screening for Prediabetes and Type 2 Diabetes

Jonas, Daniel E; Crotty, Karen; Yun, Jonathan; Middleton, Jennifer Cook; Feltner, Cynthia; Taylor‐Phillips, Sian; Barclay, Colleen; Dotson, Andrea; Baker, Claire; Balio, Casey P.; Voisin, C; Harris, Russell

doi:10.1001/jama.2021.10403

Cited by 50 publications

(51 citation statements)

References 108 publications

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“…However, the strength of evidence was graded as insufficient because follow-up was only 6 months, results were imprecise (with 0 events in either group), consistency is unknown (single study), and the study had high attrition. Among adults with obesity and overweight, recent meta-analyses for the USPSTF found high strength of evidence that lifestyle interventions were associated with reduction in the incidence of diabetes in trials with follow-up ranging from less than 1 year to 30 years (pooled relative risk, 0.78 [95% CI, 0.69-0.88]; 23 trials, 12 915 participants) …”

Section: Discussionmentioning

confidence: 99%

Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Jonas

Schaaf

Riley

et al. 2022

JAMA

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Section: Discussionmentioning

confidence: 99%

Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Jonas

Schaaf

Riley

et al. 2022

JAMA

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“…The task force recommends that adults aged 35 to 70 years who have overweight or obesity be screened for prediabetes and type 2 diabetes and that clinicians “offer or refer patients with prediabetes to effective prevention interventions” (B recommendation). The recommendation is relatively unchanged since the 2015 USPSTF statement, except for the lowering of the age threshold for screening from 40 to 35 years and the addition of metformin among diabetes prevention interventions …”

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confidence: 99%

“…In this issue of JAMA , the US Preventive Services Task Force (USPSTF) presents its Recommendation Statement and an updated Evidence Review on screening for prediabetes and type 2 diabetes. The task force recommends that adults aged 35 to 70 years who have overweight or obesity be screened for prediabetes and type 2 diabetes and that clinicians “offer or refer patients with prediabetes to effective prevention interventions” (B recommendation).…”

mentioning

confidence: 99%

“…Although this magnitude of association was less than the risk reduction reported in the 2015 report (RR, 0.53 [95% CI, 0.39-0.72]), it reflects an important expansion of the literature beyond the proof-of-concept diabetes prevention trials, such as the US Diabetes Prevention Program. The updated evidence review includes an increased number of studies, including more investigations conducted in community settings with diverse populations and longer follow-up. This, along with the scale-ups of programs seen in the US and UK, established the viability of individual-based interventions as an important approach against the diabetes epidemic …”

mentioning

confidence: 99%

“…Overcoming a gap so large calls for new ideas, new science, and perhaps new frameworks. The concept of prediabetes has often been met with skepticism because the USPSTF and American Diabetes Association–adopted definition of prediabetes (fasting plasma glucose level >100 mg/dL [5.55 mmol/L] or hemoglobin A 1c concentration >5.7%) captures a large heterogenous risk group; it extends beyond the risk definitions used in the most influential randomized clinical trials, which required an abnormal oral glucose tolerance test result to be eligible . Although multicomponent lifestyle interventions are beneficial for glycemic control and cardiovascular risk factor control across the full spectrum of risk, they are most cost-effective among groups with the highest levels and glycemic risk .…”

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New USPSTF Recommendations for Screening for Prediabetes and Type 2 Diabetes

Gregg

Moin

2021

JAMA

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Screening for Prediabetes and Type 2 Diabetes

Force¹,

Davidson

Barry

et al. 2021

JAMA

238

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ImportanceAccording to the Centers for Disease Control and Prevention 2020 National Diabetes Statistics Report, an estimated 13% of all US adults (18 years or older) have diabetes, and 34.5% meet criteria for prediabetes. 1 The prevalence of prediabetes and diabetes are higher in older adults. Of persons with diabetes, 21.4% were not aware of or did not report having diabetes, and only 15.3% of persons with prediabetes reported being told by a health profes-sional that they had this condition. 1 Estimates of the risk of progression from prediabetes to diabetes vary widely, perhaps because of differences in the definition of prediabetes or the heterogeneity of prediabetes. 2 A large cohort study of 77 107 persons with prediabetes reported that the risk of developing diabetes increased with increasing hemoglobin A 1c (HbA 1c ) level and with increasing body mass index (BMI). 3 Diabetes is the leading cause of kidney failure and new cases of blindness among adults in the US. It is also associated with increased risks of cardiovascular disease (CVD), nonalcoholic fatty liver IMPORTANCE An estimated 13% of all US adults (18 years or older) have diabetes, and 34.5% meet criteria for prediabetes. The prevalences of prediabetes and diabetes are higher in older adults. Estimates of the risk of progression from prediabetes to diabetes vary widely, perhaps because of differences in the definition of prediabetes or the heterogeneity of prediabetes. Diabetes is the leading cause of kidney failure and new cases of blindness among adults in the US. It is also associated with increased risks of cardiovascular disease, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis and was estimated to be the seventh leading cause of death in the US in 2017. Screening asymptomatic adults for prediabetes and type 2 diabetes may allow earlier detection, diagnosis, and treatment, with the ultimate goal of improving health outcomes.OBJECTIVE To update its 2015 recommendation, the USPSTF commissioned a systematic review to evaluate screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant adults and preventive interventions for those with prediabetes.POPULATION Nonpregnant adults aged 35 to 70 years seen in primary care settings who have overweight or obesity (defined as a body mass index Ն25 and Ն30, respectively) and no symptoms of diabetes.EVIDENCE ASSESSMENT The USPSTF concludes with moderate certainty that screening for prediabetes and type 2 diabetes and offering or referring patients with prediabetes to effective preventive interventions has a moderate net benefit. CONCLUSIONS AND RECOMMENDATIONThe USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions. (B recommendation)

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Screening for Prediabetes and Type 2 Diabetes

Abstract: IMPORTANCE Type 2 diabetes is common and is a leading cause of morbidity and disability.OBJECTIVE To review the evidence on screening for prediabetes and diabetes to inform the US Preventive Services Task Force (USPSTF).

Cited by 50 publications

References 108 publications

Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents

New USPSTF Recommendations for Screening for Prediabetes and Type 2 Diabetes

Screening for Prediabetes and Type 2 Diabetes

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