WASHINGTON, May 14, 2014 /PRNewswire/ -- According to the results of new research published online in Population Health Metrics, millions more American adults with undiagnosed diabetes and prediabetes could be identified using American Diabetes Association (ADA) guidelines for diabetes screening compared with using current screening guidelines of the United States Preventive Services Task Force (USPSTF).
Researchers calculated that in the year 2010, 59.1 million adults would have met the USPSTF screening criteria, and that among this population there were 24.4 million with undetected prediabetes and 3.7 million with undiagnosed type 2 diabetes. In comparison, the study showed that among the 86.3 million adults who would have met ADA screening criteria, there were 33.9 million with undetected prediabetes and 4.6 million with undiagnosed type 2 diabetes. ADA guidelines, when compared with USPSTF guidelines, detected 39% more cases of prediabetes and 24% more cases of undiagnosed type 2 diabetes.
While the USPSTF recommends diabetes screening only for asymptomatic adults with high blood pressure, ADA's guidelines include multiple risk factors in addition to high blood pressure, including overweight and obesity, age, race/ethnicity, and family history, among others.
"This research is an important addition to the literature on diabetes screening," said study co-author Dr. K.M. Venkat Narayan, Ruth and OC Hubert Professor of Global Health & Epidemiology and Professor of Medicine, Emory University. "It shows that one set of screening guidelines – those of the ADA – is more robust at identifying adults with prediabetes, which is a vital first step if we are to make serious progress as a country in providing counsel and community-based support for preventing or delaying the onset of type 2 diabetes."
According to the Centers for Disease Control and Prevention's (CDC) National Diabetes Fact Sheet, 2011, there are 79 million adults aged 20 and older with prediabetes, and research has shown that only about 11% of them are aware of their condition.
The Population Health Metrics study also shows that ADA screening guidelines are more robust at identifying adults with undiagnosed type 2 diabetes – a critical step on the path to treating the disease earlier in its progression, to improve chances of preventing the serious complications of diabetes. According to the CDC, there are approximately 7 million adults with undiagnosed diabetes.
Even better performance of the ADA guidelines was seen in an analysis of subgroups by age and race/ethnicity, where ADA guidelines would detect 78% more cases of diabetes among adults aged 54 and younger, 40% more cases in African Americans, and more than twice as many cases in Hispanic Americans.
Under a provision of the Affordable Care Act, insurers are required to cover, at no cost to the patient, preventive services that have been recommended by the USPSTF. USPSTF screening guidelines more closely aligned with those of the ADA would mean that millions of previously uninsured adults, who are now insured via the health insurance exchanges or through expansions of Medicaid, could be eligible for no-cost diabetes screenings.
Members of the Diabetes Advocacy Alliance™ (DAA) have long supported screening as integral to their support of the National Diabetes Prevention Program at the CDC, and they continue to urge Congress to increase funding for this vital effort that is bringing evidence-based diabetes prevention programs to communities across America. The DAA also supports policies and legislation that would improve diabetes treatment and care, recognizing screening as the vital first step.
"There is a strong scientific evidence base for prevention or delay of type 2 diabetes, as well as for the value of early intervention in diabetes treatment for prevention of long-term complications of the disease," said DAA co-chair Tricia Brooks, Senior Director, Public Affairs Strategy and Public Policy, Novo Nordisk Inc. "But we can't prevent type 2 diabetes or its complications if we don't effectively screen for the disease."
Whether ADA or USPSTF screening guidelines are followed is not the only challenge to more effective screening in clinical settings. According to the study, the majority of adults meeting ADA (58%) and USPSTF (70%) screening guidelines had one or more primary care office visits in 2010, indicating they had access to care yet still had not been diagnosed. For the others who had no visits to a primary care office, access to care could be a contributing factor to a lack of diagnosis.
The DAA is a coalition of 20 members, representing patient, professional and trade associations, other nonprofit organizations, and corporations, all united in the desire to change the way diabetes is viewed and treated in America. The DAA was formed and began activities in January 2010. Three members of the DAA serve as co-chairs: Academy for Nutrition and Dietetics; American Diabetes Association; and Novo Nordisk Inc. More information is available at www.diabetesadvocacyalliance.org.
Novo Nordisk Inc. commissioned the study.
SOURCE Diabetes Advocacy Alliance