Task Force recommends screening for type 2 diabetes in overweight, obese adults

The U.S. Preventive Services Task Force (USPSTF) recently issued an updated recommendation on screening for type 2 diabetes in adults.

The USPSTF's previous recommendation on this topic, published in 2008, stated that physicians should screen for type 2 diabetes in asymptomatic adults with treated or untreated sustained blood pressure greater than 135/80 mm Hg, based on the ability of screening to identify people with diabetes and evidence that more intensive blood pressure treatment was associated with reduced risk for cardiovascular events in patients with diabetes and hypertension. To update this recommendation, the USPSTF commissioned an evidence review that was published online April 14 by Annals of Internal Medicine and covered in the April 14 ACP Internist Weekly.

Based on that review, which included updated evidence showing the benefit of lifestyle modifications, the USPSTF now recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in overweight and obese adults ages 40 to 70 years. Clinicians should offer intensive behavioral counseling interventions to promote a healthful diet and physical activity in patients with abnormal blood glucose or should refer them for such interventions, the USPSTF said. This is a grade B recommendation, meaning that there is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.

The USPSTF noted that further research is needed on effects of screening in racial and ethnic minorities, the longer-term benefits and harms of lifestyle interventions and medical therapy, optimal frequency of screening, and the ideal age at which screening should start. The updated recommendation was published online Oct. 27 by Annals of Internal Medicine.