New Diabetes Screening Guidelines: Is 45 too Old?

The US Preventive Services Task Force’s updated recommendations on screening for diabetes type 2 have the American Medical Association’s (AMA) president fuming.

The USPTF recommends that all adults aged 40 to 70 years who are overweight or obese be screened for abnormal blood glucose. Those who do show signs of inadequate glucose control should then be referred for “intensive behavioral counseling interventions to promote a healthful diet and physical activity.”

That’s a lot of screening. Obesity prevalence estimates vary, but most agree Americans are way to fat. According to the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, WA, 71% of US men and 62% of US women are overweight or obese. Other estimates put the percentages closer to 50% to 40% for people 40 to 60.

But the AMA’s President Steve Stack, MD, says even more people should be screened.

“The final recommendations reduce the target population of those who should be screened for diabetes—placing significantly less emphasis on the young as well as minority populations who are at high risk for undiagnosed diabetes,” Stack said, “The AMA believes that this will only create a greater barrier to reaching the 86 million American adults currently living with prediabetes who are at high risk of developing diabetes.”

According to the task force, the American Diabetes Association recommends screening for diabetes in adults aged 45 years or older and screening in persons with multiple risk factors regardless of age. The American Association of Clinical Endocrinologists, American Academy of Family Physicians, Diabetes Australia, Diabetes UK, and the Canadian Task Force on Preventive Health Care recommend screening for diabetes in persons with risk factors only. Canada’s obesity rates are lower than those in the US.