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New Guidelines Boost Diabetes Screening for Overweight Adults

Experts see benefit in wider patient pool

More people who are overweight or obese may get screened for diabetes under new guidelines published in the Annals of Internal Medicine. Those whose blood sugar is higher than normal now can be referred to nutrition and exercise counseling without paying anything out of pocket for it.

“Obesity and overweight have been risk factors all along for diabetes,” Dr. Wanda Filer, president of the American Academy of Family Physicians, told Kaiser Health News. “But we haven’t had guidelines that actually said, ‘Screen those folks.’”

Under the Patient Protection and Affordable Care Act, insurers must cover preventive services that receive a grade of A or B from the U.S. Preventive Services Task Force, an independent panel of experts, without charging patients.

The new guidelines update the task force’s 2008 recommendation, which recommended screening asymptomatic adults if they had hypertension. After reviewing the evidence on which this recommendation was based and incorporating findings from new studies, the task force concluded that there is a moderate benefit in screening a broader pool of people for abnormal blood sugar levels, including adults between 40 and 70 years of age who are overweight or obese. The task force also concluded that current evidence is sufficient to recommend lifestyle interventions, such as diet and exercise counseling, as a way to prevent or delay the development of diabetes.

In the past, Filer said, if a 55-year-old patient was overweight and she wanted to order a blood glucose screening test, some insurers balked at covering the test. She would sometimes have to justify it by stating that the patient was complaining of fatigue, for example.

Now, insurers must cover the screening tests as well as counseling at the primary care practice office or off site at a hospital or elsewhere in the community.

“Health plans were generally supportive of this recommendation, although there are concerns about the lack of direct evidence that measuring blood glucose leads to improved health outcomes,” said Clare Krusing, a spokeswoman for America’s Health Insurance Plans, an industry trade group.

Sources: Kaiser Health News; December 4, 2015; and Annals of Internal Medicine; December 1, 2015.

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