Still Searching for Diabetes Screening

Type 2 diabetes screening of large population did not seem to lower death rates

(RxWiki News) Growing rates of diabetes continue to be a huge public health problem. Screening and early treatment could help reduce this burden. Could diabetes screening also lower death rates?

Researchers found that inviting a large population to be screened for type 2 diabetes did not reduce rates of death linked to diabetes, heart disease or cancer.

Testing for diabetes can help doctors and patients take early action to treat the disease and prevent complications. However, it is still unclear how much screening is beneficial. That is, does it help to screen everyone?

"Get tested for diabetes if you are overweight."

Rebecca K. Simmons, PhD, of the MRC Epidemiology Unit, Cambridge, UK, and colleagues set out to see if large-scale screening for type 2 diabetes could reduce death rates. Out of 16,047 high-risk patients at screening practices, just over 15,000 (94 percent) were invited to get screened. But an invitation does not necessarily mean that a patient will show up for screening; a total of 11,737 patients (73 percent) attended screening.

Of these, 466 (3 percent) were diagnosed with diabetes.

Within a decade, there were 1,532 deaths (10 percent) among patients who took part in the screening practices. In comparison, there were 377 deaths (9 percent) among those not screened.

Results showed that invitation to screening was not associated with reduced rates of heart-related deaths, cancer deaths or diabetes-related deaths. More specifically, invitation to screening did not lower rates of:

  • heart-related death, with a hazard ratio of 1.02
  • cancer death, with a hazard ratio of 1.08
  • diabetes-related death, with a hazard ratio of 1.26

A hazard ratio explains how much an event happens in one group versus another. A hazard ratio of more than 1.0 means the event happens more often in the first group than in the second. In this study, the events were heart-related death, cancer death and diabetes-related death.

The hazard ratios for heart-related death and cancer death were fairly close to 1.0, which means these death rates were fairly similar between patients invited for screening and those who were not screened.

While the hazard ratio for diabetes-related death was not significantly high, it does suggest that death rates were higher among those screened than those not screened.

According to the study's authors, "The benefits of screening might be smaller than expected and restricted to individuals with detectable disease."

In other words, screening for type 2 diabetes may only help lower death rates when patients are found to have diabetes.

The research was funded by the Wellcome Trust, UK Medical Research Council, UK National Institute for Health Research, National Health Service research and support, the University of Aarhus in Denmark and Bio-Rad. The study was published October 4 in The Lancet.

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Review Date: 
December 21, 2012