Screening for Diabetes
- Beverley Balkau, PHD
- From INSERM U780, Epidemiological and Statistical Research, Villejuif, France; and Université Paris-Sud, Orsay, France
- Corresponding author: Beverley Balkau, INSERM U780, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France. E-mail: balkau{at}vjf.inserm.fr
The U.K. National Screening Committee provides criteria against which screening programs can be evaluated (http://www.nsc.nhs.uk/pdfs/criteria.pdf). Using these criteria, screening for diabetes in the general population was deemed not to be warranted in 2001 (1) because 1) the benefits of early diagnosis and treatment had not been proved, 2) screening for diabetes to reduce cardiovascular disease had not been shown to be effective, 3) disadvantages of screening were not quantified, and 4) the clinical management of those with diabetes should be optimized before instituting a screening program.
A more recent 2007 report from the U.K. on screening for type 2 diabetes concluded that the case for screening was somewhat stronger given the possible “options for reduction of cardiovascular disease” (mainly with statins) and “because of the rising prevalence of obesity and hence diabetes” (2). Further, since the 2001 evaluation, some of the possible disadvantages of screening have been quantified and found not to be of great harm (3–5).
In this issue of Diabetes Care, the Diabetes Risk Calculator that aims to detect both undiagnosed diabetes as well as pre-diabetes is proposed (6). A number of other screening tools have already been developed in various populations and are reviewed in the U.K. report (2). In particular, for the U.S., Herman et al. (7) developed a simple questionnaire based on National Health and Nutrition Examination Survey (NHANES) II data using a classification tree approach. The questionnaire included …
