Lower Screening age for prediabetes and diabetes to 35 years, recommends USPSTF

USA: The US Preventive Services Task Force (USPSTF) has released an updated recommendation statement that lowered recommended age for screening of type 2 diabetes from 40 to 35 years in obese or overweight people. This screening age was lowered in response to the ballooning rates of prediabetes and type 2 diabetes. 

The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions.

This recommendation applies to nonpregnant adults aged 35 to 70 years seen in primary care settings who have overweight or obesity (defined as a BMI ≥25 [calculated as weight in kilograms divided by height in meters squared] and ≥30, respectively) and no symptoms of diabetes.

"Screening asymptomatic adults for prediabetes and type 2 diabetes may allow earlier detection, diagnosis, and treatment, with the ultimate goal of improving health outcomes," the authors wrote in the Journal of the American Medical Association (JAMA). 

To update its 2015 recommendation, the USPSTF commissioned a systematic review to evaluate screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant adults and preventive interventions for those with prediabetes.

The review included 89 publications with a patient population of 68,882 participants. Publications were selected for inclusion if investigators determined they answered any of the 9 key questions posed within the review. These 9 questions included inquiries related to direct evidence of screening on improving health outcomes, potential harms of screening, benefits of interventions, potential influence of age, race, sex, and ethnicity, and more.

Data points highlighted in the published review article included: 

In the recommendation statement, the authors also underlined the increased risks of cardiovascular disease, NAFLD, and nonalcoholic steatohepatitis associated with diabetes.

The USPSTF concludes with moderate certainty that screening for prediabetes and type 2 diabetes and offering or referring patients with prediabetes to effective preventive interventions has a moderate net benefit.

Reference:

"Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement," is published in JAMA. 

DOI: https://jamanetwork.com/journals/jama/fullarticle/2783414