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Only Half of U.S. Adults Over 45 Are Screened for Diabetes

Findings fall short of ADA guidance
According to a cross-sectional study published online in the American Journal of Preventive Medicine, only half of adults in the U.S. were screened for diabetes within the last 3 years, fewer than what is recommended by the American Diabetes Association.

As the rates of obesity have increased, so has the incidence of type-2 diabetes, which also increases the risk of cardiovascular disease. Up to one-third of people with diabetes are undiagnosed, the authors noted.

Lead author Sarah Stark Casagrande, PhD, explained that the prevalence of screening for diabetes in U.S. adults (20 years of age or older) was 44% and that screening focused primarily on people who were overweight and obese, probably because of increased national attention to the disease.

“Even though just over half [53%] of the people over 45 were screened for diabetes in the last 3 years, that falls far short of the American Diabetes Association recommendations that all adults over 45, even if without symptoms of diabetes, be screened,” Casagrande said. “However, we found that for minorities, such as Hispanics (known to be at greater risk), and for those with lower family income, less education, and no health insurance, diabetes screening was less prevalent.”

The researchers reviewed responses from 21,519 adults participating in the 2005–2010 National Health and Nutritional Examination Survey (NHANES) and in the 2006 National Health Interview Survey who reported diabetes screening (a blood test) within the past 3 years.

In the NHANES survey, 66% of participants were overweight, and yet only 48% had a blood screening test for diabetes. The prevalence of having a blood screening test was lower in men, Hispanics, and Mexican-Americans than in women, non-Hispanic whites, and non-Hispanic blacks.

Marjorie Cypress, PhD, president of health care and education at the American Diabetes Association, wasn’t surprised by the study’s findings because she has seen similar screening statistics. She explained various factors that play a part in screening underserved and high-risk populations: “Fear keeps some people from being screened. They’re afraid of what they may learn. Others only seek medical care when they are sick, and at that time they may not be screened for diabetes because the illness that brought them to a clinic is the priority at hand. Still others stay away from health care and screenings altogether because they don’t have health insurance, although that may be changing as more people gain coverage.”

Casagrande added: “We hope that health professionals realize that there is a large proportion of the U.S. population who are not being screened but should be according to American Diabetes Association guidelines. The fact that many of these people also have co-morbidity and potential complications of diabetes emphasizes the importance of detecting diabetes and delaying progression of these conditions.”

“We need to create a sense of urgency if we want to improve screening statistics,” Cypress said. “Instead of waiting for people to get screened, we may need to take diabetes screening to where the people are — like workplaces or churches, which may be vitally important for those who are at high risk for diabetes.” Sources: Center for Advancing Health; September 25, 2014; and AJPM; September 16, 2014.

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