|
 Earlier detection did seem to slow the progression of so-called
prediabetes to full-blown diabetes, but it had no impact on the risk
of death from heart or blood vessel disease 10 years later,
researchers found when they analyzed studies conducted from 2007 to
2014.
In 2008, the U.S. Preventive Services Task Force recommended testing
for diabetes before symptoms emerge in an effort to get millions of
undiagnosed adults on medications to lower blood sugar, cholesterol
and blood pressure before the disease worsens and complications
become harder to treat.
"Many people with early diabetes may not have symptoms, and thus do
not seek care," lead study author Dr. Shelley Selph of Oregon Health
and Science University said by email. "It is possible that 10 years
of follow-up is insufficient to detect a mortality benefit."
About 21 million Americans were diagnosed with diabetes in 2010, and
an estimated 8 million more were undiagnosed, the researchers note
in Annals of Internal Medicine. Most of them have type 2 diabetes,
which is linked to obesity and advanced age and happens when the
body can't properly use or make enough of the hormone insulin to
convert blood sugar into energy.
Diabetes is the leading cause of kidney failure, non-traumatic lower
limb amputations, and blindness. It’s also a major cause of heart
disease and stroke and the seventh-leading cause of death in the
U.S., the authors note.
Like obesity, hypertension is a risk factor for diabetes, and this
link prompted the expansion of U.S. screening guidelines to include
people with high blood pressure.
In two trials examined in the report, one of which focused on people
at greater risk for diabetes, the risk of death after 10 years was
similar whether people were screened or not. This might be due to
not enough people getting screened, or improved management of
cardiovascular disease contributing to lower mortality, the
researchers note.
There's little harm to screening, though, beyond the potential for
short-term anxiety for those who test positive for diabetes, the
report authors wrote.
[to top of second column] |
For people with pre-diabetes, with high blood sugar levels but not
full-blown disease, both medications and lifestyle changes appear
effective at delaying progression of the disease, the researchers
said.
The preventive services task force is in the process of updating its
diabetes screening guidelines, Dr. Michael Pigone, a task force
member, said by email. The group is focusing on "the effectiveness
of identifying abnormal blood sugar before it progresses to
diabetes, as well as the effectiveness of treating those who have
abnormal blood sugar with intensive lifestyle intervention."
The current report confirms more data is still needed, said Dr.
Betul Hatipoglu, an endocrinologist at Cleveland Clinic in Ohio, in
an email. "It acknowledges that prevention of diabetes is possible.
It would really be a disservice to the population at risk to not
give them their second chance to know and prevent diabetes until we
can prove that we are not helping but actually harming them by early
intervention, which will be impossible in my opinion."
The study was funded by the Agency for Healthcare Research and
Quality and done in consultation with the U.S. Preventive Services
Task Force.
SOURCE: http://bit.ly/1CBZcCg
Annals of Internal Medicine, online April 13, 2015.
[© 2015 Thomson Reuters. All rights
reserved.] Copyright 2015 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
