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MONDAY, Aug. 25, 2003 (HealthDayNews) -- Most cases of diabetes would be detected early if physicians followed currently approved guidelines, a new study finds.
Susan Weller, a professor of preventive medicine and community health at the University of Texas Medical Center, says the number of cases of diabetes is increasing dramatically.
"We count diabetes in the number of cases per hundred people, while in cancer we count the number of cases per 100,000 people. That's how common diabetes is becoming," she said.
The U.S. government's National Institutes of Health estimates there are about 17 million people with diabetes in the United States. Almost 15 million of those have Type 2, or non-insulin dependent diabetes. The study concentrated on Type 2 diabetes, Weller said.
Weller said that about a third to half of diabetes cases are undiagnosed. "And at the time of diagnosis, often the complications of diabetes are already present. This means that the disease may have been undiagnosed for 2 to 10 years," she added.
Several major medical groups have adopted screening guidelines similar to those from the American Diabetes Association, Weller said, including The International Diabetes Foundation and the American Association of Clinical Endocrinologists.
When Weller and her colleagues looked at patients who had had a fasting glucose test, they found that the guidelines would have detected almost all the cases of diabetes. They looked at patients whose medical data were collected as part of the National Health and Nutritional Examination Survey, a study of the health and diet of Americans sponsored by the National Center for Health Statistics.
The team also found that the age when a person is at risk for diabetes differs for whites compared with blacks and Hispanics. "A simple rule for detecting diabetes is to test whites at age 40 and older and non-whites at age 30 and older. Doing this, you would find almost all cases of diabetes," Weller said.
Weller's study is published in this week's issue of the Proceedings of the National Academy of Sciences.
Weller notes that testing everyone would be very expensive, but testing people with risk factors for diabetes would limit the number tested, would reduce costs and would still detect most cases.
"If you tested people with one risk factor, you could drop the amount of testing to up to 80 percent of the population and you would find 100 percent of cases. If you tested people with two risk factors, you would have to test only about 59 percent of patients and still find about 98 percent of the cases of diabetes," Weller said.
The implication of the study, according to Weller, is that physicians may not be testing for diabetes, or they may be testing only patients 45 years of age or older, thereby missing more than half of the cases of diabetes among blacks and Hispanics.
Weller believes that patients need to request diabetes testing. In an ongoing study, Weller and her team are telling patients the risk factors for diabetes and are having them ask their doctor about testing.
Risk factors include being black or Hispanic, being overweight, being older than 45, having a relative with diabetes, having high blood pressure, having high cholesterol, or if you have ever been told that you have an abnormal blood sugar reading, Weller says.
Weller said doctors should pay attention to all the risk factors "or, they can screen all whites at 40 and all blacks and Hispanics at 30."
More information
To learn more about diabetes screening, visit the National Institute of Diabetes and Digestive and Kidney Diseases or the American Diabetes Association.
