Perspective from Matthew J. O'Brien, MD
Perspective from Kim Brunisholz, PhD, MST
Source: Press Release


Disclosures: Gregg and Tseng report no relevant financial disclosures. Moin reports receiving support from the NIH/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIDDK/CDC and the U.S. Department of Veterans Affairs.
August 24, 2021
2 min read
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USPSTF makes ‘huge’ change to prediabetes, diabetes screening recommendations for adults

Perspective from Matthew J. O'Brien, MD
Perspective from Kim Brunisholz, PhD, MST
Source: Press Release


Disclosures: Gregg and Tseng report no relevant financial disclosures. Moin reports receiving support from the NIH/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIDDK/CDC and the U.S. Department of Veterans Affairs.
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The U.S. Preventive Services Task Force has published its final guidance on prediabetes and type 2 diabetes screening, lowering the recommended age in asymptomatic, nonpregnant adults who are overweight or obese to 35 years.

Clinicians are advised to screen eligible patients every 3 years and “offer or refer patients with prediabetes to effective preventive interventions,” the task force said. The recommended age to stop screening for prediabetes and type 2 diabetes remains 70 years.

The CDC estimates that among U.S. adults, 34.5% meet criteria for prediabetes and 13% have diabetes.
Reference: Jonas DE, et al. JAMA. 2021;doi:10.1001/jama.2021.10403.

The final recommendation is an update to the USPSTF’s 2015 guidance, which recommended to start screening asymptomatic, nonpregnant adults who are overweight or obese at age 40 years. However, research published since then has indicated that the 2015 recommendation would only identify about half of Americans with prediabetes and undiagnosed type 2 diabetes.

The new USPSTF B-grade recommendation is “going to make a huge difference” in the battle to bring prediabetes and diabetes under control in the United States, Chien-Wen Tseng, MD, MPH, MSE, a task force member and research director in the department of family medicine and community health at the University of Hawaii John A. Burns School of Medicine, told Healio Primary Care. The CDC estimates that 34.5% of all U.S. adults meet criteria for prediabetes and 13% of all U.S. adults have diabetes.

Chien-Wen Tseng

Many of those Americans are unaware of their diabetes status, including those who have a BMI of 25 kg/m2 or greater, Tseng said.

“Close to 20% of people don’t know that they have diabetes. Close to 85% of people don’t know they have prediabetes,” she said. “One of the biggest risk factors for diabetes or prediabetes is being overweight or obese. This affects close to three-fourths of Americans right now. So, it made a lot of sense to go down from 40 to 35.”

Tseng noted that prediabetes and diabetes screening is simple, safe and effective, and the benefits of early detection “are potentially huge.”

“The message for both clinicians and for patients is that this is really worth the time spent,” she told Healio Primary Care.

In a related editorial, Edward W. Gregg, PhD, a professor in the department of epidemiology and biostatistics at the Imperial College in London, and Tannaz Moin, MD, MBA, MSHS, an assistant professor of medicine at the David Geffen School of Medicine at UCLA, said there are “three major areas of concern that must be addressed” to combat the “diabetes epidemic.”

No. 1 was addressing “stagnated” diabetes care, particularly among underrepresented populations and adults aged 18 to 44 years; No. 2 was overcoming obstacles that could bring glycemic and cardiovascular risk factors under control among young adults with newly diagnosed diabetes; and No. 3 was increasing the number of eligible participants engaging in diabetes prevention programs.

“The greatest transformation in diabetes-related outcomes can be achieved if the problem is viewed from a longer-term perspective, whereby success is measured throughout the process and not at the beginning or the end,” Gregg and Moin wrote.

References:

Gregg EW, Moin T, et al. JAMA. 2021;doi:10.1001/jama.2021.12559.

Jonas DE, et al. JAMA. 2021;doi:10.1001/jama.2021.10403.

USPSTF, et al. JAMA. 2021;doi:10.1001/jama.2021.12531.

USPSTF. Task Force Issues Final Recommendation Statement on Screening for Prediabetes and Type 2 Diabetes. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-abnormal-blood-glucose-and-type-2-diabetes. Accessed Aug. 24, 2021.