Skip to main content
Top
Published in: Diabetologia 11/2017

01-11-2017 | Commentary

Should we screen for type 2 diabetes among asymptomatic individuals? Yes

Authors: David Simmons, Janice C. Zgibor

Published in: Diabetologia | Issue 11/2017

Login to get access

Abstract

RCTs of whether screening asymptomatic individuals for undiagnosed diabetes results in reduced mortality or has other benefits have been suggestive, but inconclusive. In this issue of Diabetologia, two additional controlled studies (DOIs: 10.​1007/​s00125-017-4323-2 and 10.​1007/​s00125-017-4299-y) that investigated whether screening for type 2 diabetes in asymptomatic individuals is associated with a reduction in mortality are presented. Treating diabetes early, and identifying and treating impaired glucose tolerance, are of benefit, and economic modelling indicates such screening is cost-effective. Now that such screening is already underway in many countries, new data, along with the existing evidence, suggests opportunistic screening is the best way forward. More research is needed, however, on how best to screen and how to improve risk-factor control once dysglycaemia is detected.
Literature
1.
go back to reference Andermann A (2008) Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bull World Health Organ 86:317–319CrossRefPubMedPubMedCentral Andermann A (2008) Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bull World Health Organ 86:317–319CrossRefPubMedPubMedCentral
2.
go back to reference Eborall HC, Griffin SJ, Prevost AT et al (2007) Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial. BMJ 335:486CrossRefPubMedPubMedCentral Eborall HC, Griffin SJ, Prevost AT et al (2007) Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial. BMJ 335:486CrossRefPubMedPubMedCentral
3.
go back to reference Dall TM, Narayan KMV, Gillespie KB et al (2014) Detecting type 2 diabetes and prediabetes among asymptomatic adults in the United States: modeling American Diabetes Association versus US Preventive Services Task Force diabetes screening guidelines. Popul Health Metrics 12:12CrossRef Dall TM, Narayan KMV, Gillespie KB et al (2014) Detecting type 2 diabetes and prediabetes among asymptomatic adults in the United States: modeling American Diabetes Association versus US Preventive Services Task Force diabetes screening guidelines. Popul Health Metrics 12:12CrossRef
4.
go back to reference Simmons RK, Echouffo-Tcheugui JB, Sharp SJ et al (2012) Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trial. Lancet 380:1741–1748CrossRefPubMedPubMedCentral Simmons RK, Echouffo-Tcheugui JB, Sharp SJ et al (2012) Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trial. Lancet 380:1741–1748CrossRefPubMedPubMedCentral
5.
go back to reference Simmons RK, Rahman M, Jakes RW et al (2011) Effect of population screening for type 2 diabetes on mortality: long-term follow-up of the Ely cohort. Diabetologia 54:312–319CrossRefPubMed Simmons RK, Rahman M, Jakes RW et al (2011) Effect of population screening for type 2 diabetes on mortality: long-term follow-up of the Ely cohort. Diabetologia 54:312–319CrossRefPubMed
6.
go back to reference Rahman M, Simmons RK, Hennings SH et al (2012) How much does screening bring forward the diagnosis of type 2 diabetes and reduce complications? Twelve year follow-up of the Ely cohort. Diabetologia 55:1651–1659CrossRefPubMed Rahman M, Simmons RK, Hennings SH et al (2012) How much does screening bring forward the diagnosis of type 2 diabetes and reduce complications? Twelve year follow-up of the Ely cohort. Diabetologia 55:1651–1659CrossRefPubMed
7.
go back to reference Simmons RK, Griffin SJ, Witte DR et al (2017) Effect of population screening for type 2 diabetes and cardiovasular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults. Diabetologia doi:10.1007/s00125-017-4323-2 Simmons RK, Griffin SJ, Witte DR et al (2017) Effect of population screening for type 2 diabetes and cardiovasular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults. Diabetologia doi:10.​1007/​s00125-017-4323-2
8.
go back to reference Simmons RK, Griffin SJ, Lauritzen T, Sandbæk A (2017) Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009. Diabetologia doi:10.1007/s00125-017-4299-y Simmons RK, Griffin SJ, Lauritzen T, Sandbæk A (2017) Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009. Diabetologia doi:10.​1007/​s00125-017-4299-y
10.
go back to reference Pringle M, Stewart-Evans C, Coupland C, Williams I, Allison S, Sterland J (1993) Influences on control in diabetes mellitus: patient, doctor, practice, or delivery of care? BMJ 306:630–634CrossRefPubMedPubMedCentral Pringle M, Stewart-Evans C, Coupland C, Williams I, Allison S, Sterland J (1993) Influences on control in diabetes mellitus: patient, doctor, practice, or delivery of care? BMJ 306:630–634CrossRefPubMedPubMedCentral
11.
go back to reference Griffin SJ, Borch-Johnsen K, Davies MJ et al (2011) Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. Lancet 378:156–167CrossRefPubMedPubMedCentral Griffin SJ, Borch-Johnsen K, Davies MJ et al (2011) Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. Lancet 378:156–167CrossRefPubMedPubMedCentral
13.
go back to reference Simmons D, Yu D, Bunn C, Cohn S, Wenzel H, Prevost T (2015) Hospitalization among patients with diabetes associated with a diabetes impact initiative: a mixed methods case study. Future Hospital J 2:92–98 Simmons D, Yu D, Bunn C, Cohn S, Wenzel H, Prevost T (2015) Hospitalization among patients with diabetes associated with a diabetes impact initiative: a mixed methods case study. Future Hospital J 2:92–98
14.
go back to reference Holman RR, Paul SK, Bethel MA et al (2008) 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 359:1577–1589CrossRefPubMed Holman RR, Paul SK, Bethel MA et al (2008) 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 359:1577–1589CrossRefPubMed
15.
go back to reference The Action to Control Cardiovascular Risk in Diabetes Study Group (2008) Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 358:2545–2559CrossRefPubMedCentral The Action to Control Cardiovascular Risk in Diabetes Study Group (2008) Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 358:2545–2559CrossRefPubMedCentral
16.
go back to reference Zinman B, Wanner C, Lachin JM et al (2015) Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 373:2117–2128CrossRefPubMed Zinman B, Wanner C, Lachin JM et al (2015) Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 373:2117–2128CrossRefPubMed
18.
go back to reference Diabetes Prevention Research Group (2016) Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes study. Lancet Diabetes Endocrinol 3:866–875 Diabetes Prevention Research Group (2016) Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes study. Lancet Diabetes Endocrinol 3:866–875
19.
go back to reference Echouffo-Tcheugui JB, Prorok PC (2014) Considerations in the design of randomized trials to screen for type 2 diabetes. Clin Trials 11:284–291CrossRefPubMed Echouffo-Tcheugui JB, Prorok PC (2014) Considerations in the design of randomized trials to screen for type 2 diabetes. Clin Trials 11:284–291CrossRefPubMed
23.
go back to reference Church D, Simmons D (2014) More evidence of the problems of using HbA1c for diagnosing diabetes? The known knowns, the known unknowns and the unknown unknowns. J Intern Med 276:171–173CrossRefPubMed Church D, Simmons D (2014) More evidence of the problems of using HbA1c for diagnosing diabetes? The known knowns, the known unknowns and the unknown unknowns. J Intern Med 276:171–173CrossRefPubMed
24.
go back to reference Waugh NR, Shyangdan D, Taylor-Phillips S, Suri G, Hall B (2013) Screening for type 2 diabetes: a short report for the National Screening Committee. Health Technol Assess 17:1–90PubMedPubMedCentral Waugh NR, Shyangdan D, Taylor-Phillips S, Suri G, Hall B (2013) Screening for type 2 diabetes: a short report for the National Screening Committee. Health Technol Assess 17:1–90PubMedPubMedCentral
26.
go back to reference Engelgau MM, Narayan KM, Herman WH (2000) Screening for type 2 diabetes. Diabetes Care 23:1563–1580CrossRefPubMed Engelgau MM, Narayan KM, Herman WH (2000) Screening for type 2 diabetes. Diabetes Care 23:1563–1580CrossRefPubMed
Metadata
Title
Should we screen for type 2 diabetes among asymptomatic individuals? Yes
Authors
David Simmons
Janice C. Zgibor
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 11/2017
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-017-4397-x

Other articles of this Issue 11/2017

Diabetologia 11/2017 Go to the issue

Up front

Up front