PMID- 25131213
OWN - NLM
STAT- MEDLINE
DCOM- 20150608
LR  - 20211021
IS  - 1873-2607 (Electronic)
IS  - 0749-3797 (Print)
IS  - 0749-3797 (Linking)
VI  - 47
IP  - 4
DP  - 2014 Oct
TI  - Reconsidering the age thresholds for type II diabetes screening in the U.S.
PG  - 375-81
LID - S0749-3797(14)00226-8 [pii]
LID - 10.1016/j.amepre.2014.05.012 [doi]
AB  - BACKGROUND: Type II diabetes and its complications can sometimes be prevented, if 
      identified and treated early. One fifth of diabetics in the U.S. remain 
      undiagnosed. Commonly used screening guidelines are inconsistent. PURPOSE: To 
      examine the optimal age cut-point for opportunistic universal screening, compared 
      to targeted screening, which is recommended by U.S. Preventive Services Task 
      Force (USPSTF) and American Diabetes Association (ADA) guidelines. METHODS: 
      Cross-sectional analysis of a nationally representative sample from the National 
      Health and Nutrition Examination Survey, 2007-2010. Number of people needed to 
      screen (NNS) to obtain one positive test result was calculated for different 
      guidelines. Sampling weights were applied to construct national estimates. The 
      2010 Medicare fee schedule was used for cost estimation. Analysis was conducted 
      in January 2014. RESULTS: NNS, under universal screening, drops sharply at age 35 
      years, from 80 (30-34-year-olds) to 31 (35-39-year-olds). Opportunistic universal 
      screening of eligible people aged >/=35 years would yield an NNS of 15, translating 
      to $66 per positive test. Among people aged 35-44 years (who are not recommended 
      for universal screening by ADA), most (71%) were overweight or obese and all had 
      at least one other ADA risk factor. Only 34% of individuals aged >/=35 years met 
      USPSTF criteria. Strictly enforcing USPSTF guidelines would have resulted in a 
      majority (61%) of potential positive test cases being missed (5,508,164 cases 
      nationwide). CONCLUSIONS: Opportunistic universal screening among individuals 
      aged >/=35 years could greatly reduce the national prevalence of undiagnosed 
      pre-diabetes or diabetes at relatively low cost.
CI  - Copyright (c) 2014 American Journal of Preventive Medicine. Published by Elsevier 
      Inc. All rights reserved.
FAU - Chung, Sukyung
AU  - Chung S
AD  - Palo Alto Medical Foundation Research Institute, Palo Alto. Electronic address: 
      chungs@pamfri.org.
FAU - Azar, Kristen M J
AU  - Azar KM
AD  - Palo Alto Medical Foundation Research Institute, Palo Alto.
FAU - Baek, Marshall
AU  - Baek M
AD  - Palo Alto Medical Foundation Research Institute, Palo Alto.
FAU - Lauderdale, Diane S
AU  - Lauderdale DS
AD  - Department of Health Studies, University of Chicago, Chicago, Illinois.
FAU - Palaniappan, Latha P
AU  - Palaniappan LP
AD  - Palo Alto Medical Foundation Research Institute, Palo Alto; Stanford Prevention 
      Research Center, Department of Medicine, Stanford University School of Medicine, 
      Stanford, California.
LA  - eng
GR  - K01 HS019815/HS/AHRQ HHS/United States
GR  - R01 DK081371/DK/NIDDK NIH HHS/United States
GR  - UL1 TR000430/TR/NCATS NIH HHS/United States
GR  - 1R01DK081371-01A1/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20140815
PL  - Netherlands
TA  - Am J Prev Med
JT  - American journal of preventive medicine
JID - 8704773
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*diagnosis/epidemiology/prevention & control
MH  - Humans
MH  - Mass Screening/*methods
MH  - Middle Aged
MH  - Nutrition Surveys
MH  - Obesity/complications/*epidemiology
MH  - Overweight/complications/*epidemiology
MH  - Practice Guidelines as Topic
MH  - Prevalence
MH  - Risk Factors
MH  - United States/epidemiology
MH  - Young Adult
PMC - PMC4171212
MID - NIHMS623832
COIS- No financial disclosures were reported by the authors of this paper.
EDAT- 2014/08/19 06:00
MHDA- 2015/06/09 06:00
PMCR- 2015/10/01
CRDT- 2014/08/19 06:00
PHST- 2013/12/11 00:00 [received]
PHST- 2014/04/18 00:00 [revised]
PHST- 2014/05/12 00:00 [accepted]
PHST- 2014/08/19 06:00 [entrez]
PHST- 2014/08/19 06:00 [pubmed]
PHST- 2015/06/09 06:00 [medline]
PHST- 2015/10/01 00:00 [pmc-release]
AID - S0749-3797(14)00226-8 [pii]
AID - 10.1016/j.amepre.2014.05.012 [doi]
PST - ppublish
SO  - Am J Prev Med. 2014 Oct;47(4):375-81. doi: 10.1016/j.amepre.2014.05.012. Epub 
      2014 Aug 15.