New Guidelines Encourage Early Screening for Diabetes and Prediabetes
By Karena Yan and Ursula Biba
The US Preventive Services Task Force (USPSTF) has updated its recommendations, encouraging prediabetes screening for people with high body weight starting at age 35, and promoting lifestyle interventions.
The US Preventive Services Task Force (USPSTF) released a new draft recommendation for prediabetes and diabetes screening in people who are overweight or have obesity. If approved, the task force will recommend that people between the ages of 35 to 70 be screened for prediabetes and type 2 diabetes every three years.
Further, if individuals are diagnosed with prediabetes, the guidelines advise that they be directed toward preventive lifestyle interventions or the glucose-lowering medication metformin.
These recommendations are an update to the 2015 guidelines, which recommended screenings beginning at 40 years old for people with a body mass index (BMI) above 25. The 2015 recommendations focused on identifying unusual blood glucose levels as part of regular heart screening, rather than recognizing prediabetes.
This year’s updates are an attempt to identify prediabetes early. Of the estimated 34 million US adults with diabetes in 2018, about one in five (21%) were undiagnosed and only 15% were previously diagnosed with prediabetes. Screening and early detection can not only prevent or delay diabetes development but it may also prevent diabetes from progressing to a more severe state with other health complications. The CDC estimates that 88 million people in the US alone currently have prediabetes and that most of them don’t know it. No doubt, addressing this issue is a major reason for the USPSTF taskforce work.
Beyond body weight, the recommendations also suggest that healthcare professionals consider other factors for prediabetes screening, including race and medical history. The guidelines recommend screening individuals who belong to racial and ethnic groups showing higher rates of diabetes at younger ages and lower BMIs. Diabetes is most prevalent in indigenous populations (14.7%), followed by Latinx (12.5%), Black (11.7%), Asian (9.2%), and non-Hispanic white populations (7.5%). In addition, screening is suggested for people who have a history of diabetes, gestational diabetes, or polycystic ovarian syndrome – all of which could increase one’s likelihood of developing type 2 diabetes.
If you think you may be at risk for diabetes or prediabetes, talk to your healthcare team and ask what screening options they would recommend for you. If you have diabetes, discuss screening with your family and friends who have risk factors.