Release Date: February 2003
Summary of Recommendations / Supporting Documents
Rating: I Recommendation.
Rationale: The USPSTF found good evidence that available screening tests can accurately detect type 2 diabetes during an early, asymptomatic phase. The USPSTF also found good evidence that intensive glycemic control in patients with clinically detected (not screening detected) diabetes can reduce the progression of microvascular disease. However, the benefits of tight glycemic control on microvascular clinical outcomes take years to become apparent. It has not been demonstrated that beginning diabetes control early as a result of screening provides an incremental benefit compared with initiating treatment after clinical diagnosis. Existing studies have not shown that tight glycemic control significantly reduces macrovascular complications including myocardial infarction and stroke. The USPSTF found poor evidence to assess possible harms of screening. As a result, the USPSTF could not determine the balance of benefits and harms of routine screening for type 2 diabetes.
Rating: B Recommendation.
Rationale: The USPSTF found good evidence that, in adults who have hypertension and clinically detected diabetes, lowering blood pressure below conventional target blood pressure values reduces the incidence of cardiovascular events and cardiovascular mortality; this evidence is considered fair when extrapolated to cases of diabetes detected by screening. Among patients with hyperlipidemia, there is good evidence that detecting diabetes substantially improves estimates of individual risk for coronary heart disease, which is an integral part of decisions about lipid-lowering therapy.
Screening for type 2 Diabetes Mellitus in Adults, February 2003
Recommendations and Rationale (PDF File, 96 KB)
Review of the Evidence (PDF File, 135 KB)
Systematic Evidence Review (File Download; PDF Files Download)
What's New (PDF File, 73 KB)
Guide to Clinical Preventive Services, 2nd Edition
Screening for Diabetes Mellitus, 1996
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U.S. Preventive Services Task Force (USPSTF)