2019 Screening Guidelines Would Label More as T2DM Cases
Benefit would be limited because ID'd cases would have HbA1c levels below pharmacotherapy targets
FRIDAY, June 19, 2020 (HealthDay News) -- Adopting the 2019 Endocrine Society guidelines for diabetes screening would substantially increase the number of older adults classified as having type 2 diabetes but would likely offer limited benefits, according to a study recently published in Diabetes Care.
Michael Fang, Ph.D., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues evaluated the impact of the 2019 Endocrine Society screening guidelines on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation. Data from the 2005 to 2016 National Health and Nutrition Examination Survey were used to identify 2,236 adults aged ≥65 years without known diabetes.
The researchers found that diabetes prevalence was 15.7 percent (about 5.0 million) using the Endocrine Society approach and 7.3 percent (about 2.3 million) using the standard approach. Based on hemoglobin A1c (HbA1c) cut points (≥7 to ≥9 percent), treatment eligibility ranged from 5.4 to 0.06 percent using the Endocrine Society approach and 11.8 to 1.3 percent for the standard approach. It is estimated that screening all older adults with prediabetic HbA1c/fasting plasma glucose (about 18.3 million) with an oral glucose tolerance test could cost $737 million to $1.7 billion.
"Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits," the authors write.