Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
|Population||Adults aged 40 to 70 y who are overweight or obese|
|Recommendation||Screen for abnormal blood glucose. Offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to promote a healthful diet and physical activity.
|Risk Assessment||Risk factors for abnormal glucose metabolism include overweight and obesity or a high percentage of abdominal fat, physical inactivity, and smoking. Abnormal glucose metabolism is also frequently associated with other cardiovascular risk factors, such as hyperlipidemia and hypertension.|
|Screening Tests||Glucose abnormalities can be detected by measuring hemoglobin A1c or fasting plasma glucose or with an oral glucose tolerance test. Diagnosis of IFG, IGT, or type 2 diabetes should be confirmed with repeated testing (the same test on a different day is the preferred method of confirmation).|
|Screening Interval||Evidence on the optimal rescreening interval for adults with an initial normal glucose test is limited. Studies suggest that rescreening every 3 y may be a reasonable approach.|
|Treatment and Interventions||Effective behavioral interventions combine counseling on a healthful diet and physical activity and involve multiple contacts over extended periods. There is insufficient evidence that medications have the same benefits as behavioral interventions.|
|Balance of Benefits and Harms||The overall benefit of screening for IFG, IGT, and diabetes and implementing intensive lifestyle interventions is moderate.|
|Other Relevant USPSTF Recommendations||The USPSTF recommends screening and appropriate interventions for modifiable risk factors for cardiovascular events (overweight and obesity, physical inactivity, abnormal lipid levels, high blood pressure, and smoking). These recommendations are available at https://www.uspreventiveservicestaskforce.org.|
For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to www.uspreventiveservicestaskforce.org.
Abbreviations: IFG = impaired fasting glucose; IGT = impaired glucose tolerance.
Internet Citation: Clinical Summary: Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening. U.S. Preventive Services Task Force. April 2019.