Diabetes Screening Might Not Help Everyone

Diabetes screening may not be useful for patients with no symptoms

(RxWiki News) Screening may be one of the best ways to catch and fight diseases like cancer early, but the effectiveness of screening for diabetes may be a little less clear in some patients.

A recent study found that screening for type 2 diabetes did not reduce the number of patient fatalities 10 years down the road. However, catching high blood sugar early did appear to help keep some patients from developing diabetes.

Shelley Selph, MD, of Oregon Health & Science University in Portland, led this study.

"This systematic review for the U.S. Preventive Services Task Force found that screening for type 2 diabetes mellitus did not affect mortality but that treatment of impaired fasting glucose [blood sugar] and impaired glucose tolerance delayed progression to diabetes," Dr. Selph and team wrote.

Type 2 diabetes is marked by the body being unable to properly process insulin (a hormone that regulates blood sugar). This renders the body unable to control blood sugar levels. Untreated diabetes can lead to kidney failure, lower-limb amputations, heart disease and stroke.

Diabetes can be detected through a blood test. However, an estimated 8 million cases of diabetes went undetected in 2010, Dr. Selph and team noted. These researchers set out to see whether early detection of diabetes or prediabetes (and subsequent treatment to control blood sugar levels) would result in improved patient outcomes.

Current standards only recommend screening patients who aren't showing symptoms if they have a sustained blood pressure greater than 135 over 80. A raised blood pressure may increase the risk of heart disease. Patients with diabetes often have improved cardiovascular outcomes when on blood pressure medication.

In this study, Dr. Selph and team reviewed studies published from 2007 to 2014 to determine the benefits of screening for diabetes. They found that the risk of death was the same in patients who were screened and those who went unscreened after 10 years.

However, treatment for poor blood sugar levels did appear to delay the progression to type 2 diabetes. Why this delay did not translate into improved longevity after 10 years was unclear.

There is little evidence on the harms of diabetes screening, but this review found that the benefits may be limited for certain patients. Dr. Selph and team noted that anxiety upon initial screening or diagnosis was one of the more common downsides of screening. There is also a limited risk tied to some of the drugs used to treat early-stage diabetes. These risks would be eliminated if no early diagnosis was made. However, progression to full diabetes will likely occur more quickly without treatment.

Dr. Selph and team called for more research to clarify whether diabetes screening in patients without symptoms is beneficial. Patients worried about their diabetes risk should see a doctor to determine the best course of action.

This study was published online April 13 in the Annals of Internal Medicine.

The Agency for Healthcare Research and Quality funded this research. Dr. Selph and team disclosed no conflicts of interest.

Review Date: 
April 12, 2015