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News & InformationCDC Statements on Diabetes IssuesScreening for Type 2 DiabetesThis is a summary and interpretation of the technical review article recently published by scientists from the Centers for Disease Control and Prevention's (CDC) Division of Diabetes Translation (DDT) on screening for type 2 diabetes.
1. What was the purpose of the technical review? The purpose of the review was to examine the scientific evidence and policy implications for screening for undiagnosed diabetes. 2. What are the major findings from the CDC's technical review on screening for undiagnosed diabetes? Criteria supporting screening for diabetes include
Criteria not supporting screening include
The authors concluded that population-based and selective screening programs in community settings, such as outreach programs, health fairs, and shopping malls, have uniformly demonstrated low yield and poor follow-up. Such screening usually does not represent a good use of resources. Periodic screening of high-risk individuals as part of ongoing medical care may be warranted, understanding that evidence in support of this is incomplete. Questions remain about the optimal screening methods, best cutpoint measurements for a positive test to use to identify those with diabetes, and how often to screen people not at high risk for diabetes. 3. What are the review's implications for screening for undiagnosed diabetes? Based on the results of this study, opportunistic screening can be considered by health care delivery systems. However, screening outside the clinic setting is not warranted. It is also noted that people with symptoms of diabetes and those who have clinical signs and symptoms of diabetes should be tested and diagnosed. When people have signs or symptoms that suggest diabetes, clinicians should maintain a high index of suspicion and pursue diagnostic testing. This activity is considered to be an appropriate diagnostic effort and shows good clinical care. Screening only applies to people who are truly asymptomatic. 4. How are these findings different from the American Diabetes Association (ADA) recommendations? Currently, the ADA recommends that all adults aged 45 years and older be considered for diabetes screening by their health care provider every 3 years. The authors and others from CDC's DDT discussed the results of this study with ADA representatives and other diabetes expert groups to help develop recommendations that are consistent with these new findings. See ADA, which revised its recommendations in Diabetes Care 2003;26:S21-S24.* 5. How was the technical review conducted? The authors conducted a comprehensive review of the world's literature on the subject. Essential criteria required for diabetes screening to be an appropriate activity were evaluated and included the following:
6. What should CDC's state and territorial diabetes control programs (DPCPs) be doing in the area of screening for undiagnosed diabetes? DPCPs should be working with health care systems, such as managed care organizations, to consider opportunistic diabetes screening as a potentially valuable measure for certain subpopulations and minorities. * Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link. Return to the Finnish Study
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Page last modified: December 20, 2005 Content Source: National Center for Chronic Disease Prevention and Health Promotion Division of Diabetes Translation |