The American Diabetes Association (Association) applauds the U.S. Preventive Services Task Force (USPSTF) for elevating the draft recommendation for Screening of Type 2 Diabetes Mellitus in Adults, released yesterday. The USPSTF’s draft recommendation will now include multiple risk-factor based type 2 diabetes screening for asymptomatic patients in addition to screening those who have high blood pressure, which was previously the only screening guideline under the existing recommendation last updated in 2008.
In issuing today’s draft recommendation, the USPSTF has taken into consideration the abundance of evidence demonstrating that risk-factor based screening for type 2 diabetes will identify more individuals with the disease. Today, 8 million of the nearly 30 million children and adults in the U.S. living with diabetes have not been diagnosed with the disease. The estimated economic cost of undiagnosed diabetes is a staggering $18 billion annually. It is crucial to identify these cases in order for patients to engage in proper diabetes management and prevent costly and dangerous complications, including cardiovascular disease, stroke blindness, amputation and kidney disease.
“The American Diabetes Association is thrilled with the decision of the U.S. Preventive Services Task Force to strengthen their recommendation and take into consideration the wealth of research pointing to the need for risk-factor based screening in type 2 diabetes,” said Robert Ratner, MD, Chief Scientific & Medical Officer, American Diabetes Association. “Early diagnosis of both type 2 and prediabetes is essential in improving the outcomes for these patients. Undeniable data show the efficacy and cost effectiveness of preventing diabetes. This new draft recommendation is a step in the right direction in the ongoing fight to Stop Diabetes®.”
The American Diabetes Association has long advocated for risk-factor based screening for type 2 diabetes in our annual Standards of Medical Care in Diabetes. There are a number of factors associated with type 2 diabetes, including advanced age, being overweight or obese, family history of type 2 diabetes, and being a member of certain minority population that increase a patient’s risk for type 2 diabetes. Using risk-factor based screenings will lead to diagnosing more individuals who are living with undiagnosed type 2 diabetes, but also help to identify those with prediabetes who are at high risk for developing type 2 and once diagnosed, can work to prevent the development of type 2 diabetes.
A 2013 study in the American Journal of Preventive Medicine found screening using the current USPSTF recommendations results in missing more than half of those who have undiagnosed diabetes. The decision to broaden the screening recommendation is an essential step to improving diabetes health outcomes, as these recommendations offer guidance to health care providers on providing appropriate preventive care. Additionally, under the Affordable Care Act, preventive services that receive A or B ratings are covered through private insurance without cost-sharing. This means individuals at risk will have greater access to diabetes screening if the draft recommendation stands. As the USPSTF continues the process of developing the final recommendation, the Association applauds the efforts to improve screening guidelines and urges the USPSTF to uphold the draft recommendation.