Early detection of diabetes could be improved by the newest US Preventive Services Task Force (USPSTF) criteria for screening, according to a study published in Journal of General Internal Medicine.

In 2015, USPSTF had recommended screening for prediabetes and undiagnosed diabetes (collectively called dysglycemia) among adults aged 40–70 years with overweight or obesity (referred to as limited criteria). The USPSTF also suggested, but did not formerly recommend, earlier screening in people with certain diabetes risk factors, including a history of gestational diabetes, polycystic ovarian syndrome, membership of an ethnic/racial minority, or a family history of diabetes (expanded criteria).

To compare these limited and expanded screening criteria, O'Brien from Northwestern University Feinberg School of Medicine, Chicago, USA, and colleagues conducted a cross-sectional study using the data of 3643 adults without diagnosed diabetes enrolled in National Health and Nutrition Examination Surveys study.

Screening eligibility according to the limited criteria was based on age 40-70 years old and overweight/obesity. Screening eligibility according to the expanded criteria was determined by meeting the limited criteria or having more than one of the following risk factors: family history of diabetes, history of gestational diabetes or polycystic ovarian syndrome, and non-white race/ethnicity. Dysglycemia was defined by A1c ≥ 5.7%, FPG ≥ 100 mg/dL, and/or 2-h PG ≥ 140 mg/dL.

Interestingly, the study demonstrated that using the USPSTF’s limited criteria of age and BMI would pick up only 47% of those with an abnormal glucose. At the same time, using the expanded criteria would detect 77% of those with abnormal blood glucose levels. "The earlier patients are diagnosed with these conditions, the sooner they can begin to combat them," O'Brien added.

Using the expanded criteria on the basis of other high-risk factors (gestational diabetes, polycystic ovarian syndrome, racial/ethnic minority, and/or family history of diabetes) can thus improve detection of abnormal blood glucose levels. Early screening and detection, would allow for earlier pharmacotherapy and lifestyle modification, potentially warding off more serious complications of diabetes.

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