Diabetes guidelines: Screen more people earlier

All adults who are overweight and have additional risk factors for type 2 diabetes are candidates for prediabetes testing, say the new recommendations.

By Susan J. Landers, AMNews staff. Jan. 21, 2008.

Washington -- Stopping diabetes before it starts is the aim of several new recommendations intended to help physicians in the fight to curb the spread of the disease, which affects 7% of the population.

Screening more widely for patients with prediabetes and stepping up preventive measures for those who have started down the path toward type 2 diabetes are among the suggestions made recently by the American Diabetes Assn.

Progression to diabetes among those with impaired glucose tolerance or impaired fasting glucose -- conditions commonly referred to as prediabetes -- is not inevitable, according to the Centers for Disease Control and Prevention.

The ADA provides several tips for physicians, including considering the use of the diabetes medication metformin, to prevent, or at least delay, the full-blown disease. The group's "Standards of Medical Care in Diabetes -- 2008" are in the Jan. 1 Diabetes Care and are updated annually.

The alarming growth in the number of people, particularly youngsters, who have type 2 diabetes has sparked concern about the need to make a preemptive strike to prevent, if possible, the disease and its serious complications, which include heart disease, stroke, blindness and kidney disease. More than 14 million people have been diagnosed with diabetes, and another 6 million are undiagnosed, according to the CDC.

Richard Hellman, MD, president of the American Assn. of Clinical Endocrinologists, praised the ADA recommendations. "I think they have changed, improved and strengthened many parts of their standards."