Screening for Diabetes Mellitus, Adult type 2

U.S. Preventive Services Task Force

Release Date: February 2003

Summary of Recommendations / Supporting Documents

Summary of Recommendations

• The USPSTF concludes that the evidence is insufficient to recommend for or against routinely screening asymptomatic adults for type 2 diabetes, impaired glucose tolerance, or impaired fasting glucose. 

  Rating: I Recommendation.

  Rationale: The USPSTF found good evidence that available screening tests can accurately detect type 2 diabetes during an early, asymptomatic phase. The USPSTF also found good evidence that intensive glycemic control in patients with clinically detected (not screening detected) diabetes can reduce the progression of microvascular disease. However, the benefits of tight glycemic control on microvascular clinical outcomes take years to become apparent. It has not been demonstrated that beginning diabetes control early as a result of screening provides an incremental benefit compared with initiating treatment after clinical diagnosis. Existing studies have not shown that tight glycemic control significantly reduces macrovascular complications including myocardial infarction and stroke. The USPSTF found poor evidence to assess possible harms of screening. As a result, the USPSTF could not determine the balance of benefits and harms of routine screening for type 2 diabetes.

• The USPSTF recommends screening for type 2 diabetes in adults with hypertension or hyperlipidemia.

  Rating: B Recommendation.

  Rationale: The USPSTF found good evidence that, in adults who have hypertension and clinically detected diabetes, lowering blood pressure below conventional target blood pressure values reduces the incidence of cardiovascular events and cardiovascular mortality; this evidence is considered fair when extrapolated to cases of diabetes detected by screening. Among patients with hyperlipidemia, there is good evidence that detecting diabetes substantially improves estimates of individual risk for coronary heart disease, which is an integral part of decisions about lipid-lowering therapy.

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Supporting Documents

Screening for type 2 Diabetes Mellitus in Adults, February 2003
Recommendations and Rationale (PDF File, 96 KB; PDF Help)
Review of the Evidence (PDF File, 135 KB; PDF Help)
Systematic Evidence Review (PDF Files Download)
What's New (PDF File, 73 KB; PDF Help)

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Current as of February 2003

Internet Citation:

Screening for type 2 Diabetes Mellitus in Adults, Topic Page. February 2003. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/uspstf/uspsdiab.htm