Who and why should we screen for diabetes?

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Why should we care about diabetes screening?  Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease.

Does it work?  Screening patients before signs and symptoms has been found to lead to earlier diagnosis (and treatment!) but has not been found to reduce rates of end-organ damage– meaning kidney and heart failure.  Studies have found that screening for type 2 diabetes does not reduce mortality after 10 years, but maybe the patient sees benefits after 23 to 30 years.

There are differing opinions of when to screen.  The US Preventive Services Task Force suggests screening overweight or obese patients who are 40 to 70 years old.  If blood sugar results are normal, then this glucose lab should be repeated every three years.  If an individual is at “higher risk” then screening can be done earlier and more frequently than every 3 years.  Whereas the American Diabetes Association suggests that patients 45 years and older are screened yearly for their blood sugar.  If patients have major risk factors of diabetes like obesity, then patients can be screened younger than 45 years old.

What lab values are significant?  Diabetes can be made with a fasting plasma glucose more than 126 or a hemoglobin A1c more than 6.5%.  Results of fasting blood sugar should be confirmed with a repeat test.  A single random blood sugar more than 200 is also indicative of diabetes.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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