Prediabetes and type 2 diabetes are significant health concerns in the United States, with an estimated 13% of all US adults (18 years or older) having diabetes, and 34.5% meeting criteria for prediabetes.
The prevalence of these conditions is higher in older adults, and they are associated with increased risks of cardiovascular disease, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. Early detection and treatment of prediabetes and type 2 diabetes are crucial for improving health outcomes.
The Importance of Screening
Screening for prediabetes and type 2 diabetes in asymptomatic adults may allow earlier detection, diagnosis, and treatment, ultimately leading to better health outcomes. The US Preventive Services Task Force (USPSTF) recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity.
The USPSTF Recommendation
The USPSTF concludes with moderate certainty that screening for prediabetes and type 2 diabetes and offering or referring patients with prediabetes to effective preventive interventions has a moderate net benefit. The recommendation is based on a systematic review of the evidence on screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant adults and preventive interventions for those with prediabetes.
Key Findings
- The prevalence of prediabetes and diabetes is higher in older adults.
- Estimates of the risk of progression from prediabetes to diabetes vary widely, perhaps due to differences in the definition of prediabetes or the heterogeneity of prediabetes.
- Diabetes is the leading cause of kidney failure and new cases of blindness among adults in the US.
- It is also associated with increased risks of cardiovascular disease, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis.
Screening Tests
Screening tests for prediabetes and type 2 diabetes include measurement of fasting plasma glucose or hemoglobin A1c (HbA1c) level or an oral glucose tolerance test. The optimal screening interval for adults with an initial normal glucose test result is uncertain, but screening every 3 years may be a reasonable approach for adults with normal blood glucose levels.
Preventive Interventions
Preventive interventions for prediabetes include lifestyle interventions, such as diet and physical activity, and pharmacological interventions, such as metformin. Lifestyle interventions have been shown to be effective in reducing the progression to type 2 diabetes, as well as reducing other cardiovascular risk factors such as blood pressure and lipid levels.
Conclusion
Screening for prediabetes and type 2 diabetes is an important step in the prevention and management of these conditions. The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity, and offering or referring patients with prediabetes to effective preventive interventions. Early detection and treatment of prediabetes and type 2 diabetes can lead to better health outcomes and a reduced risk of complications.
Additional Resources
For more information on prediabetes and type 2 diabetes, including diagnosis, prevention, and treatment, please visit the Centers for Disease Control and Prevention (CDC) website at www.cdc.gov/diabetes. The National Institutes of Health (NIH) also has several resources available on screening, diagnosis, prevention, and management of prediabetes and type 2 diabetes at www.niddk.nih.gov.
