Screening for diabetes: is it warranted?
BACKGROUND
Diabetes mellitus is estimated to have a worldwide prevalence of 4.6% and afflict 200 million people. The prevalence is accelerating rapidly and the disease has reached epidemic proportions. While type 1 diabetes usually has a dramatic clinical onset, almost half of all those individuals with type 2 diabetes have not been diagnosed. This observation, coupled with the presence of complications at diagnosis and the significant reduction of microvascular complications obtained with tight glycemic control, has led to the recommendation that screening for diabetes be instituted. The American Diabetes Association recommends that adults aged 45 years or more should be evaluated for diabetes by measuring fasting plasma glucose concentrations.


CONCLUSIONS
The rationale for screening, evidence that tight glycemic control reduces complications, and the possible roles of Hb A(1c) and autoantibodies in screening strategies are addressed in this review.
Greenberg
Roger A
RA
Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02215, USA.
Sacks
David B
DB
D001786:Blood Glucose / Q000032:analysis; D002940:Circadian Rhythm; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000191:economics / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D005215:Fasting; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis / Q000592:standards; D017408:Guidelines as Topic; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D008403:Mass Screening; D008875:Middle Aged; D009098:Multiphasic Screening / Q000379:methods; D012680:Sensitivity and Specificity
D001786:Blood Glucose; D006442:Glycated Hemoglobin