USPSTF Lowers Recommended Screening Age for Type 2 Diabetes

Chien-Wen Tseng, MD, MPH

In response to ballooning rates of prediabetes and type 2 diabetes, the US Preventive Services Task Force (USPSTF) has lowered the recommended starting age of screening for type 2 diabetes.

The latest recommendation statement from the organization, which was published in the Journal of the American Medical Association, lowers the recommended screening age from 40 to 35 years for type 2 diabetes and the recommend screening age for prediabetes and type 2 diabetes in asymptomatic adults with overweight or obesity from ages 35-70 years.

“Clinicians can prevent serious health complications by screening adults with overweight or obesity for prediabetes and diabetes," said Task Force member Chien-Wen Tseng, MD, MPH, MSEE, in a statement from the USPSTF. "With appropriate screening, diabetes can be detected and treated earlier to improve overall health."

With the last USPSTF recommendation on the topic coming in 2015, the USPTF conducted a review of available data to evaluate screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant adults and preventive interventions for those with prediabetes. In their 2015 recommendation, the USPSTF recommended screening for abnormal blood glucose levels as part of a cardiovascular risk assessment in patients 40-70 years who have overweight or obesity. In the updated recommendation statement, the USPSTF recommends screening for prediabetes and type 2 diabetes adults 35-70 who have overweight or obesity as well as recommending clinicians refer patients with prediabetes to effective preventive interventions. Additionally, the latest recommendation also recommends beginning screening for type 2 diabetes at 35 years.

Related: Recent study examines rising rates of type 1 and type 2 diabetes in US youth.

The review used to make these recommendations included 89 publications with a patient population of 68,882 participants. Publications were selected for inclusion if investigators determined they answered any of the 9 key questions posed within the review. These 9 questions included inquiries related to direct evidence of screening on improving health outcomes, potential harms of screening, benefits of interventions, potential influence of age, race, sex, and ethnicity, and more.

Data points highlighted in the published review article included reductions in all-cause mortality seen with screening at a younger age, improvements in health outcomes seen among overweight persons with intensive glucose control, and improvements associated with lifestyle interventions, such as weight loss, reduced BMI, and blood pressure reductions. In the recommendation statement, authors also underlined the increased risks of cardiovascular disease, NAFLD, and nonalcoholic steatohepatitis associated with diabetes.

“Fortunately, there are interventions that are effective for preventing prediabetes from progressing to diabetes and in helping people with prediabetes improve their health,” says Task Force vice chair Michael Barry, MD. “The Task Force encourages clinicians to screen adults over age 35 with overweight or obesity and work with them to determine if an intervention is needed.”

This recommendation statement, titled “Screening for Prediabetes and Type 2 Diabetes,” and evidence report, titled “Screening for Prediabetes and Type 2 Diabetes Updated Evidence Report and Systematic Review for the US Preventive Services Task Force,” were published in JAMA.