Chapter 8. The Evidence to Screen for Type 2 Diabetes Mellitus

  1. R. Williams2,
  2. W. Herman3,
  3. A.-L. Kinmonth5 and
  4. N. J. Wareham4
  1. Michael M. Engelgau and
  2. K. M. Venkat Narayan

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch8

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Engelgau, M. M. and Narayan, K. M. V. (2002) The Evidence to Screen for Type 2 Diabetes Mellitus, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch8

Editor Information

  1. 2

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 3

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 4

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 5

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. Division of Diabetes Translation Mailstop K-10, 477 Buford Highway NE, Atlanta, GA 30341-3724, USA

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • screening;
  • screening test;
  • sensitivity;
  • specificity;
  • diabetes;
  • economics;
  • cost effectiveness;
  • economic model

Summary

Whether we should screen for undiagnosed type 2 is controversial. Diabetes imposes a significant health burden, has a well characterized natural history, a preclinical (asymptomatic) state during which it can be diagnosed, and reliable tests that can detect the preclinical state. However, no clinical trials examining the benefits of early detection are available and it is unclear whether screening is a good use of resources. Despite the lack of evidence for diabetes screening, several health organizations have already decided to recommend it. Indirect examination of the potential benefits of screening using data from treatment of diagnosed diabetes, observational studies, and disease models lend some support to the idea that early improvement in glycaemic control may help reduce the lifetime occurrence of microvascular disease. The physical, psychological and social effects of screening and early diagnosis and treatment remain unclear. On balance, there is only modest evidence supporting screening for type 2 diabetes.