Screening for Type 2 diabetes—should it be now?

Abstract

Type 2 diabetes does not fulfil the criteria for population-based mass screening. No screening and intervention studies have been performed, systematically evaluating the positive and negative effects of screening. Furthermore, intervention studies up until now have been restricted to clinically diagnosed patients with diabetes, and most of these have recruited patients with long diabetes duration and early complications. These groups will have a worse prognosis and thus probably show greater benefits of such intervention. Finally, the psychosocial and health economic consequences of screening and intervention for Type 2 diabetes are largely unknown. Thus, systematic screening and intervention trials should be encouraged, and meanwhile intensified case finding and opportunistic screening in high-risk groups should be performed.

Progression from impaired fasting glucose and impaired glucose tolerance to diabetes in a high-risk screening programme in general practice: the ADDITION Study, Denmark

“…Normally, screening strategies are based on progression rates from general populationbased studies referred to in textbooks and guidelines. Our study confirms that these are too low for high-risk settings, which would be the preferable strategy as general popula- tion-based screening programmes are expensive [11], logistically difficult and of questionable benefit [12,13].…”

Type 2 Diabetes Mellitus in Family Practice: Prevention and Screening

“…Figure 2 outlines our summary of the criteria currently used by a variety of international health organisations to evaluate population screening. Based on such criteria, there is as yet no justification for population-based screening for Type 2 Diabetes (Borch-Johnsen et al, 2003;Waugh et al, 2007;Wareham & Griffin, 2001), although the case is becoming stronger. Whilst Type 2 Diabetes meets many of the criteria for screening, the main argument against population-based screening is that uncertainty remains about the true benefits arising from the early detection of Type 2 Diabetes through such programmes.…”

Populatiescreening op diabetes mellitus type 2 levert weinig op

“…4,5 Om deze redenen zou men kunnen overwegen de bevolking te screenen op diabetes; er is dan ook een roep om zo'n screening. Het nut daarvan is niet bewezen 6 , maar de American Diabetes Association acht opportunistische screening op diabetes van hoogrisicogroepen in een klinische setting wel geïndiceerd. 7 Niemand weet eigenlijk hoe screening op diabetes het best kan worden uitgevoerd.…”