Early detection of undiagnosed diabetes mellitus: a US perspective.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100883450 Publication Model: Print Cited Medium: Print ISSN: 1520-7552 (Print) Linking ISSN: 15207552 NLM ISO Abbreviation: Diabetes Metab Res Rev Subsets: MEDLINE

Original Publication: Oxford, England : Wiley-Blackwell, c1999-

Diabetes Mellitus, Type 2/*diagnosis; Blood Glucose/analysis ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/physiopathology ; Diabetes Mellitus, Type 2/therapy ; Diabetic Angiopathies/epidemiology ; Diabetic Angiopathies/physiopathology ; Guidelines as Topic ; Humans ; Mass Screening ; United States/epidemiology

Undiagnosed Type 2 diabetes has become a common condition in the US, comprising one-third of all cases of the disease. We believe that screening for and detection of undiagnosed Type 2 diabetes is an important endeavor. In this review we provide evidence that diabetes is a condition that is appropriate for population screening and detection. This includes evidence that: 1. Type 2 diabetes is a significant health problem. It affects more than 16 million adults in the US and places these individuals at high risk for serious complications of the eyes, nerves, kidneys, and cardiovascular system. 2. There is a latent phase before diagnosis of Type 2 diabetes. During this period of undiagnosed disease, risk factors for diabetic micro- and macrovascular complications are markedly elevated and diabetic complications are developing. 3. Diagnostic criteria for diabetes have been established and are based on plasma glucose values. These criteria define a group of individuals with significant hyperglycemia who also have a high frequency of risk factors for micro- and macrovascular disease. 4. The natural history of Type 2 diabetes is understood. In most patients, diabetes proceeds inexorably from genetic predisposition, through the stage of insulin resistance and hyperinsulinemia, to beta cell failure and overt clinical disease. 5. There are effective and acceptable therapies available for Type 2 diabetes and its complications. Treating hyperglycemia to prevent complications is more effective than treating these complications after they have developed. Furthermore, guidelines for treatment to prevent cardiovascular disease in people known to have diabetes are more stringent than in those individuals who are not known to have diabetes. 6. There is a suitable test for screening for undiagnosed Type 2 diabetes that has high sensitivity and specificity - measurement of fasting plasma glucose. Guidelines for identifying persons at high risk for diabetes have been established.
(Copyright 2000 John Wiley & Sons, Ltd.)

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Comment in: Diabetes Metab Res Rev. 2000 Jul-Aug;16(4):228-9. (PMID: 10934450)

0 (Blood Glucose)

Date Created: 20000810 Date Completed: 20000911 Latest Revision: 20191104

20240627

10.1002/1520-7560(2000)9999:9999<::aid-dmrr122>3.0.co;2-w

10934451