Screening for type 2 diabetes and prediabetes should begin from age 35 for people who are considered overweight. Instead of the current recommended age of 40, a draft guideline by the US Task Force recommends preventive services.
The update, triggered by the rise in the number of overweight or obese Americans, could result in millions more being eligible for blood work as part of regular medical exams. The guidelines are specifically for people who are overweight – a body mass index of 25 to 30 – or overweight people with a BMI of 30 or more. Obesity is a major risk factor for diabetes.
At least 31 million adults in the United States have type 2 diabetes, the seventh leading cause of death in the country, according to the Centers for Disease Control and Prevention. Diabetes can cause serious health problems, including heart disease, kidney failure, stroke, blindness, and limb amputation. Prediabetes is higher than normal blood sugar levels that don’t reach the diabetes threshold but may develop into a disease.
“We know that the rate of prediabetes and diabetes is increasing in younger people,” said Dr. Chien-Wen Tseng, task force member and professor of family medicine at the John A. Burns School of Medicine, University of Hawaii. “Our main reason for lowering age is to tailor the screening to the problem: if diabetes and prediabetes happen at a younger age, we should screen at a younger age.”
It is currently unknown how many people with prediabetes will develop diabetes later, Tseng said. “We know there is an increased risk of developing diabetes, but we don’t know exactly what the percentage is,” she added. “And we don’t know who is most likely to get diabetes. Early screening will tell us who should be monitored more often. “
The task force’s pooled analysis of 23 previous studies involving 12,915 participants with prediabetes found that lifestyle changes reduced the risk of developing diabetes by 22 percent, rather than reducing risk based on age, gender, race, ethnicity or BMI depended.
For most people, lifestyle changes, including healthier eating habits and increased activity, can bring blood sugar under control, Tseng said.
The new guidelines are important because early intervention can not only improve diabetes control but also reduce the risk of chronic kidney and cardiovascular disease, said Dr. Emily Gallagher, Assistant Professor of Medicine, Endocrinology, Diabetes, and Bone Diseases at the Icahn School of Medicine on Mount Sinai.
“Diabetes is the leading cause of kidney disease and blindness in the US and these are preventable diseases,” she said in an email. “Unfortunately, people still often don’t know that they have diabetes [until] You develop a complication such as a heart attack or a foot ulcer. “
It is also important for clinicians to consider screening at an earlier age and lower BMI in certain minority groups, including African American, Native American, Native American, Asian American, Hispanic / Latino, Native to Hawaiian / Pacific Islander, and people with families History of diabetes, a history of gestational diabetes, or polycystic ovarian disease, Gallagher said.
According to Dr. Matthew O’Brien, Associate Professor of Medicine and Preventive Medicine at Northwestern University’s Feinberg School of Medicine, more adults with diabetes and prediabetes are likely to be identified with this lowered age limit. In addition, the new screening criteria are likely to result in more diagnoses of prediabetes and diabetes in black and Hispanic people, he said in an email.
A 2016 study by Northwestern University conducted in government-funded community health centers found that 6.3 percent of white patients ages 40 and younger would develop diabetes within three years. The proportion of black patients aged 40 and younger who developed diabetes during the same period was 11.1 percent and that of Hispanic patients was 17.6 percent.
“Previous research has shown that awareness of prediabetes and diabetes leads to improved lifestyle that will help manage these conditions and prevent related complications,” said O’Brien.