Routine Screening Tests in Diabetics Unnecessary

Routine screening tests for coronary artery disease (CAD) in patients with type 2 diabetes who have not had symptoms of angina or do not have a history of heart disease may be unnecessary, a new study from Yale University’s School of Medicine has found.

Lawrence Young, MD, a professor of medicine at the Yale School of Medicine and lead author of the study, and his colleagues set out to determine if regular screening for CAD in diabetic patients without a history of heart problems can help to identify those at risk for cardiac problems. The study states that the rates of cardiac events “were not significantly reduced” as a result of the screenings.

The 1,123 patients participating in the study were followed from August 2000 to September 2007, with the average amount of follow-up time being 4.8 years. Seven nonfatal MIs and 8 cardiac deaths occurred in the group that was given the screening tests, whereas 10 nonfatal MIs and 7 cardiac deaths occurred in the group that was not screened.

In addition, the routine screening tests initially led to “more invasive procedures such as cardiac catheterization, stents or bypass.” The screening procedure can also be expensive — each test costs about $1,000, according to the press release from Yale.

According to CDC, about 16.8 million people in the US were living with diabetes in 2006, which would lead to a cost of about $16,800,000,000 to perform screening tests on all patients with type 2 diabetes.

“Routine screening would have tremendous economic implications and our findings did not indicate that routine stress testing had additional benefit in this population,” Young said.

However, he added that screening tests must not be ruled out for all patients with type 2 diabetes.

“Stress testing has an important role in evaluating patients with type 2 diabetes who have symptoms suggesting heart disease, since these individuals are at very high risk,” Young said.