Abstract
Aims. This study assessed whether recent screening recommendations have led to increased diagnosis of type 2 diabetes mellitus (T2DM) through routine screening. Methods. Respondents to the 2006 US SHIELD survey reported whether a physician told them they had T2DM, age at diagnosis, specialty of the physician who made the diagnosis, and whether the diagnosis was made after having symptoms, during routine screening, or when being treated for another health problem. Results. Of 3 022 T2DM respondents, 36% of respondents reported that T2DM diagnosis was made during routine screening alone, 20% after having symptoms alone, and 6% when being treated for another health problem alone. The proportion of T2DM respondents reporting a diagnosis based only on screening increased approximately 42% over a 15+-year time span (absolute increase from 31% to 44%) (P < .001), whereas symptom-based diagnosis did not change significantly (P = .10). T2DM was diagnosed primarily by family physicians (88.3%). Conclusion. These findings highlight the importance of regular screening for diabetes and the vital role of primary care physicians in recognizing individuals with T2DM.
Highlights
An estimated 20.6 million adults in the United States have diabetes mellitus [1]
Respondents with type 2 diabetes mellitus reported that they had had the condition for an average of 10 years (Table 1)
22% of respondents received the diagnosis of type 2 diabetes mellitus ≥15 years previously, compared with 14% of respondents who were diagnosed
Summary
An estimated 20.6 million adults in the United States have diabetes mellitus [1]. In patients newly diagnosed with type 2 diabetes, complications are often present at the time of diagnosis, suggesting that clinical onset of the disease occurred years prior to diagnosis [2, 3]. The American Diabetes Association (ADA) endorses screening of individuals at high risk for diabetes but indicates that there is insufficient evidence to support cost-effective screening of all asymptomatic individuals [5]. The ADA recommends screening be considered at 3-year intervals beginning at age 45, and in adults with body mass index (BMI) ≥ 25 kg/m2 and who have additional risk factors (e.g., family history of diabetes, physical inactivity, certain races/ethnicities, hypertension, dyslipidemia).
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