USPSTF Draft Recommendation: Screen High-Risk Adults for Type 2 Diabetes

By Kristin J. Kelley

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Adults at high risk for diabetes should be screened for type 2 diabetes and insulin resistance, the U.S. Preventive Services Task Force concludes in a grade B draft recommendation (i.e., the net benefit of screening is moderate).

The task force's 2008 review found insufficient evidence for measuring blood glucose in asymptomatic adults. The new recommendation is based on data from six new lifestyle intervention studies and longer follow-up on four studies from the earlier review.

Being high risk is defined as any one of the following: being aged 45 years and older, being overweight or obese, or having a first-degree relative with diabetes.

The USPSTF found that treating impaired fasting glucose and impaired glucose tolerance delays the progression to diabetes mellitus and recommends behavioral modifications (healthy eating, increased physical activity). Moreover, using drug therapy to prevent diabetes carries only small-to-moderate harms. After 10 years' follow-up, however, screening for diabetes did not improve cardiovascular morbidity or mortality.