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Screening Tests for Young Adults (Ages 19-29)

Type 2 Diabetes

One third of the 20 million Americans who have diabetes don’t even know it. Another 40 million have been tested and learned they have prediabetes. Recognizing prediabetes lets you take steps to stop or slow the development of type 2 diabetes, heart disease, and stroke. Diabetes, the sixth leading cause of death in the United States, has become an even more alarming problem because it is occurring more often at a younger age. Overweight, obesity, and physical inactivity, all contributing factors, have also become national health problems.

Diabetes leads to expensive complications and serious disabilities, including damage to the eyes, kidneys, nerves, and heart. Early detection of problems gives you the chance to make changes and take medicine that can help prevent type 2 diabetes from developing.

Many of the current guidelines advise a selective, rather than universal, approach to screening for diabetes mellitus. For example, the recommendations of the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) emphasize who should “consider” getting tested (who should discuss it with their health care provider) and for whom testing is “strongly recommended.”

  • For those younger than 45, if you are overweight and have one or more risk factors (listed below), you should consider testing.

A fasting plasma glucose (FPG) test or a 2-hour oral glucose tolerance test (OGTT) can be used to screen for diabetes.

The American Diabetes Association suggests how often to repeat the test:  

  • Testing should begin at an earlier age than the recommended 45 and be repeated sooner than every 3 years if you are overweight and have additional risk factors.

Know your risk factors
Your family:

  • Your sister, brother, or parent has or had diabetes.
  • You are of Latino/Hispanic, African, Asian, Native American, Native Alaskan, or Pacific Island descent.

Your health:

  • You are overweight or have a sedentary lifestyle.
  • You have hypertension, cholesterol levels (triglycerides or high-density lipoproteins) of concern, heart or vascular disease, or a severe psychiatric illness.
  • Prior tests showed you had impaired glucose tolerance or impaired fasting glucose.

Women’s health issues:

Although the U.S. Preventive Services Task Force reported that it could not, for its February 2003 recommendation, determine the balance of benefits and harms of universal screening, it does recommend the following:

  • Adults with hypertension or cholesterol levels of concern should be screened for type 2 diabetes.

Links
NIDDK: Am I at Risk for Type 2 Diabetes?
National Heart, Lung, and Blood Institute: Calculate your body mass index
To sign up for a personal diabetes test scheduling reminder, click here.

Sources

ACE/AACE Diabetes Road Map Task Force. Road maps to achieve glycemic control in type 2 diabetes mellitus. May/Jun 2007. Endocr Pract 13:260-268. PDF available on the Internet at http://www.aace.com/meetings/consensus/odimplementation/roadmap.pdf through http://www.aace.com. Accessed 18 Feb 2008.

American Diabetes Association. Standards of medical care in diabetes—2008 (position statement). Jan 2008. Diabetes Care 31:S12-S54. Available on the Internet through http://www.care.diabetesjournals.org. Accessed 18 Feb 2008.

National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health. National diabetes statistics (NIH pub. 06–3892). Nov 2005. Available on the Internet at http://diabetes.niddk.nih.gov/dm/pubs/statistics/index.htm#12 through http://diabetes.niddk.nih.gov. Accessed 19 Feb 2008.

National Institute for Diabetes and Digestive Kidney Diseases, National Institutes of Health. Am I at risk for type 2 diabetes? (NIH pub. 04-4805). Apr 2004. Available on the Internet at http://www.diabetes.niddk.nih.gov/dm/pubs/riskfortype2/index.htm#4 through http://www.diabetes.niddk.nih.gov. Accessed 19 Jul 2004; revision of Dec 2006 accessed 15 Feb 2008.

American Diabetes Association. Screening for type 2 diabetes. Jan 2004. Diabetes Care 27:S11-14. Brief summary, available on the Internet through http://www.guideline.gov. Accessed 19 Jul 2004.

National Center for Chronic Disease Prevention and Health Promotion, Diabetes Public Health Resource, US Centers for Disease Control and Prevention. CDC statements on diabetes issues: screening for type 2 diabetes. 18 Jun 2004. Available on the Internet at http://www.cdc.gov/diabetes/news/docs/screening.htm through http://www.cdc.gov. Accessed 19 Jul 2004 and 15 Feb 2008.

Matfin G and Guven S. Diagnosing Diabetes Mellitus: do we need new criteria? Available on the Internet, from the American Association of Clinical Endocrinologists, at http://www.aace.com/clin/fcc/fcc-200001.php through http://www.aace.com. Accessed 19 Jul 2004.

Mayer-Davis EJ, D’Antonia A, Tudor-Locke C. Lifestyle for diabetes prevention. In: Diabetes in the Life Cycle and Research: A Core Curriculum for Diabetes Education (5th ed.). Franz MJ, ed. American Association of Diabetes Educators. 2003; p. 3.

US Preventive Services Task Force. Screening for Diabetes Mellitus, adult type 2. Feb 2003. Available on the Internet at http://www.ahrq.gov/clinic/uspstf/uspsdiab.htm through http://www.ahrq.gov. Accessed 19 Jul 2004 and 15 Feb 2008.

Sherwin RS, et al. Prevention or delay of type 2 diabetes. Jan 2004. Diabetes Care 27:S47-S54. Available on the Internet through http://care.diabetesjournals.org. Accessed 19 Jul 2004 from the National Guideline Clearinghouse and 15 Feb 2008.