Screening is the testing of specific group in a population, i.e. a certain gender or specific age group who has an increased risk of having a certain disease. The test should be performed before symptoms appear. With the results giving you the risk of developing the disease.
Currently there are 3 million people with diabetes in theUK. It is predicted that this number will almost double by 2025, with 90% being type-2 diabetes. WHO criteria classifies Pre-diabetes as fasting plasma glucose level from 6.1 mmol/l (110 mg/dL) to 6.9 mmol/L (125 mg/dL). It is predicted that a 1/7 of adults in theUKhave impaired glucose toleration and around 10% of those will go on to develop type 2 diabetes.
Prediabetes can be screened combining fasting blood glucose level with risk factors such as ethnicity; weight; first-degree relative with type 2 diabetes; low birth weight and sedentary lifestyle. NICE recommends that high-risk patients should be offered a programme encouraging them to change their lifestyle and lower the risk of developing type 2 diabetes.
However, there are also problems with the screening test:
- There are false positives: only 12% of those with positive results will develop diabetes. This can lead to anxiety,
- Age- at what age should this be offered? and when the screening should be stopped. Current recommendation is it should be offered to all those at high risk between aged between 30-45
