New draft guidelines from the U.S. Preventive Services Task Force (USPSTF) recommend screening adults aged 45 and older for prediabetes and type 2 diabetes. The recommendation could mean identifying and treating undiagnosed diabetes in millions more people, preventing complications and improving quality of life.

An independent expert panel under the U.S. Agency for Healthcare Research and Quality, the USPSTF makes evidence-based recommendations about clinical preventive services. It issued its updated recommended guidelines for prediabetes and type 2 diabetes screening last week. The guidelines are open for public comment through Nov. 3.

The recommendation calls for screening everyone beginning at 45 years of age and patients who meet one or more of these criteria:

  • Younger adults with risk factors, including obesity
  • Younger adults with a first-degree relative with diabetes
  • Women with a history of gestational diabetes or polycystic ovarian syndrome
  • Certain racial or ethnic minority groups, including African Americans, American Indians/Alaskan Natives, Asian Americans, Hispanics/Latinos and Native Hawaiians/Pacific Islanders

The guidelines recommend the use of hemoglobin A1c testing as a primary method for screening at-risk individuals, which provides a rapid and accurate method of testing for both prediabetes and diabetes.

An estimated 86 million Americans have prediabetes, but only one in nine of these people knows they are at risk of developing type 2 diabetes. Studies suggest diabetes prevalence has as much as tripled in recent decades, and data show about two in five Americans will develop type 2 diabetes at some point in their lives.

The AMA is working to prevent diabetes through its Improving Health Outcomes initiative, partnering with the YMCA of the USA to increase referrals to the YMCA’s Diabetes Prevention Program. The program is an evidence-based lifestyle intervention that is part of the Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program.

Physician practice sites in four states—Delaware, Florida, Indiana and Minnesota—are screening patients for prediabetes and referring them to the program at their local YMCAs. Participating physicians receive updates on their patients’ progress to incorporate into their care plans.

If the USPSTF adopts the draft guidelines, adults who meet the specified criteria would be eligible for screening, and most insurers would eventually be required to cover the screening. The guidelines would be more closely aligned with those of the American Diabetes Association, and the primary care professional societies that follow USPSTF guidelines would align their screening criteria as well.

“For the first time, the USPSTF is recognizing value in screening for prediabetes,” said AMA President Robert M. Wah, MD. “Consequently, millions more patients at risk could ultimately be identified and helped by diabetes prevention programs recognized by the CDC through its National Diabetes Prevention Program.”

Physicians can comment on the draft guidelines through Nov. 3.

You tell us: How do you think the new guidelines recommended by the USPSTF will help your patients? Leave a comment below at AMA Wire®.

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