Despite an increase in awareness and public health efforts, the diabetes epidemic in America persists. The CDC estimates 21 million Americans were living with diabetes as of 2010 with 1.5 million new cases being diagnosed each year. There are also an estimated 8 million Americans unknowingly living with diabetes.
In 2008, in response to this growing problem, the US Preventive Services Task Force (USPSTF) advised all physicians to screen for diabetes in any patient with a sustained blood pressure greater than 135/80. They based this recommendation on the prevalence of the diabetes in society as well as the burden it places on a patient s body (brain, heart, kidneys). Also contributing to this advisory was a belief that the recommendation would not pose a serious detriment to patient health, citing only the possibility for increased anxiety from a pre-diabetes diagnosis.
This week, a study of this directive was published in the Annals of Internal Medicine and the results appear to challenge its efficacy. The researchers performed an intensive literature review that spanned seven years worth of publications in order to review the USPSTF s 2008 recommendation of extensive screening.
The review did find that screened patients who were diagnosed with either impaired fasting glucose or impaired non-fasting glucose did experience a delay in the onset of full diabetes. Unfortunately, the main result showed that pre-screening for diabetes did not lead to an improvement in mortality rates in a ten-year follow up. An increased screening program, like this one, should reduce mortality rates to be considered effective. These results are therefore very discouraging as we search for ways to curtail this epidemic.
It should be cautioned that the release of this study is only considered preliminary and will not at least initially change the USPSTF s recommendation to screen all patients with elevated blood pressure. Currently, they are reaching out for public comments and are expected to synthesize all factors into a new recommendation in the near future.