Evidence Tips the Scale Toward Screening for Hyperglycemia.

Abstract

Screening and early detection for hyperglycemia is a topic of considerable interest, and there is debate as to its overall benefits (1). Policies for screening vary from the position of the American Diabetes Association (2), which recommends glucose testing in all people aged 45 years and over or at high risk for type 2 diabetes, to the position of the U.S. Preventive Services Task Force (USPSTF), which recommends only testing those with sustained hypertension (3). The USPSTF, however, is deliberating its new draft recommendations, which broaden the criteria for type 2 diabetes and prediabetes screening (http://www.uspreventiveservicestaskforce.org/Page/Document/draft-research-plan49/screening-for-abnormal-glucose-and-type-2-diabetes-mellitus). As screening and early detection for hyperglycemia remains a topic of great interest, the article from Herman et al. (4) in this issue of Diabetes Care is timely. Specifically, Herman et al. (4) report on the beneficial effect of type 2 diabetes screening on cardiovascular (CVD) morbidity and mortality in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION-Europe) trial. Diabetes is a global problem, affecting 387 million people worldwide (5), that is growing in all countries, in urban and rural areas and projected to affect approximately 600 million individuals by 2035 (5). Type 2 diabetes (accounting for about 95% of all diabetes cases) often exists asymptomatically (6), and approximately 50% of cases globally (varying from 30% to 80% across countries) remain undiagnosed (1). Eighty percent of people with diabetes live in developing countries, and the majority of those affected are aged 40–59 years (5). In addition …