Diabetes Screening and Surveillance Programmes

Abstract

Although non-insulin-dependent diabetes mellitus is a common and serious disease, it is estimated that about half of the people with the disease are unaware of it, making it a candidate for early detection and screening. To date however, there is no universal agreement regarding the best screening method or the target population. Early treatment should improve long term prognosis but this remains to be proven. During the screening process, many people will be found to have blood glucose levels thought to represent the ‘pre-clinical’ stage of diabetes. Although results of some recent studies are encouraging, there has not been any definitive proof that early detection and intervention can prevent this group from developing overt diabetes. This is currently the subject of a major clinical trial. Therefore, to reduce the burden of diabetes, it is equally important to have programmes supporting early screening and treatment of diabetic complications in patients known to have the disease. Establishing screening programmes to identify patients at high risk of developing complications, and concentrating intervention efforts on this group at an early stage, has great potential to reduce both the personal and economic burden of this chronic disease.