USPSTF Diabetes Screening Guidelines Could Miss Half of Patients with Dysglycemia

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The U.S. Preventive Services Task Force’s (USPSTF) screening criteria for diabetes could miss roughly half of dysglycemia cases, according to a PLOS Medicine study. (In 2015, the USPSTF recommended screening patients for diabetes if they were aged 40–70 and overweight or obese.)

Using electronic medical records from 2008–2013, researchers studied over 50,000 adults without prediabetes or diabetes at baseline. Roughly 8500 patients developed dysglycemia during 1.9 years’ follow-up. The USPSTF’s criteria had a sensitivity of 45% and a specificity of 72% for detecting dysglycemia. Ethnic minorities were at greater dysglycemia risk than whites but were less likely to be eligible for screening.

The authors conclude: "Our findings suggest that primary care providers should consider screening patients from racial/ethnic minority groups before the age and weight ranges recommended by the USPSTF. Such a practice could enable earlier management of dysglycemia in these high-risk groups but may impose cost sharing on patients."