Screening for Type 2 Diabetes
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The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
It is estimated that 16 million Americans have ]]>prediabetes]]>. This condition is characterized by high blood glucose levels that are not high enough to be diagnosed as diabetes. But, the condition often progresses to ]]>type 2 diabetes]]>.
In order to detect prediabetes and take steps to prevent its progression to type 2 diabetes, the American Diabetes Association (ADA) recommends the following guidelines:
- Screening in adults of any age who are overweight or ]]>obese]]> with one or more of these risk factors:
- First-degree relative with diabetes
- Low HDL (good) cholesterol level and ]]>high triglycerides]]> levels
- ]]>High blood pressure]]>
- History of diabetes during pregnancy (]]>gestational diabetes]]>) or having a baby weighing over nine pounds (4.1 kg)
- Having ]]>polycystic ovary syndrome]]> or other conditions associated with insulin resistance
- Being inactive
- History of cardiovascular disease
- Belonging to an at-risk ethnic group (African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander)
- Previous blood test results that show hemoglobin A1c (HbA1c) levels at 5.7% or higher, impaired glucose tolerance, and impaired fasting glucose
- Screening in adults aged 45 and older with or without risk factors
- Screening in overweight children aged 10 years and older who have two of the following risk factors:
- High ]]>body mass index]]> (BMI) based on child's weight and height
- Family history of diabetes
- Signs of insulin resistance or having a condition associated with insulin resistance
- At-risk ethnic background
If the results are normal for both adults and children, the ADA recommends screening again in three years.
As part of your routine physical exam, your doctor may draw some blood to check your liver, kidney, and endocrine functions, including blood glucose. This blood is taken any time of day, without regard to when you have last eaten. A measure of 200 milligrams per deciliter (mg/dl) [11.1 mmol/L] may indicate diabetes. In this case, your doctor will do further testing to determine if you have diabetes.
Blood glucose testing is often done at health fairs, as well. Here, you will need to give only a few drops of blood from your fingertip, and you will have results within a few minutes. If the results indicate that your blood glucose level is high, you should see your doctor for further testing. Keep in mind, though, that the results from a health fair screening are not as accurate as the tests that your doctor does.
AACE Diabetes Mellitus Clinical Practice Guidelines Task Force. Medical guidelines for the clinical practice for the management of diabetes mellitus. American Association of Clinical Endocrinologists website. Available at: http://www.aace.com/pub/pdf/guidelines/DMGuidelines2007.pdf. Published 2007. Accessed February 12, 2010.
Agency for Healthcare Research and Quality. Task force issues two recommendations on diabetes screening for adults and pregnant women [news release]. February 3, 2003.
American Diabetes Association. American Diabetes Association position statement: standards of medical care in diabetes 2010. Diabetes Care. 2010;33:S1-S99.
American Diabetes Association website. Available at: http://www.diabetes.org . Accessed February 12, 2010.
Endocrine Society website. Available at: http://www.endo-society.org. Accessed February 12, 2010.
Gillis CL, Abrams KR, Lambert PC, et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Brit Med J. 2007;334:299-302.
Harris R, Donahue K, Rathore SS, et al. Screening adults for type 2 diabetes: a review of the evidence for the US Preventive Services Task Force. Ann Intern Med . 2003;138(3):215-229.
US Preventive Services Task Force. Screening for type 2 diabetes mellitus in adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148:846-54.
US Preventive Services Task Force. Screening for type 2 diabetes mellitus in adults: recommendations and rationale. Ann Intern Med . 2003;138(3):212-214.
2/15/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-61).
2/15/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-69).
Last reviewed February 2010 by ]]> Bridget Sinnott, MD, FACE]]>
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