Screening Criteria Can Miss Over Half of Adults with Prediabetes Interview with:
“Diabetes Mellitus” by Steve Davis is licensed under CC BY 2.0Matthew James O’Brien MD

Assistant Professor, Medicine
General Medicine Division
Assistant Professor, Preventive Medicine
Northwestern University What is the background for this study? What are the main findings?

Response: The USPSTF is an expert group that makes recommendations for screening and other preventive services. In December 2015, they recommend that providers screen for diabetes in patients who are 40-70 years old and also overweight/obese. The same recommendation stated that clinicians “should consider screening earlier” in patients who have any of the following risk factors: non-white race/ethnicity, family history of diabetes, or personal history of gestational diabetes or polycystic ovarian syndrome. Using nationally representative data, we studied the performance of the “limited” criteria based on age and weight alone vs. the “expanded criteria” mentioned above.

The main findings were that following the “limited” screening criteria of age and weight would result in missing over 50% of adults with prediabetes and diabetes. In other words, if providers followed the “limited” criteria, over 50% of adults with prediabetes and diabetes would not get screened. The “expanded” criteria exhibited much better performance, resulting in 76.8% of adults with prediabetes and diabetes who would be screened. What should readers take away from your report?

Response: Clinicians should screen for diabetes based on a more expansive set of risk factors for diabetes that are well established. This is in line with the recommendations from other expert groups, including the American Diabetes Association. What recommendations do you have for future research as a result of this work?

Response: Future research should examine how these screening criteria perform prospectively, and examine their impact on diabetes prevention and treatment in the screened population. 

No disclosures


J Gen Intern Med. 2018 Apr 12. doi: 10.1007/s11606-018-4436-4. [Epub ahead of print]
Performance of the 2015 US Preventive Services Task Force Screening Criteria for Prediabetes and Undiagnosed Diabetes.
O’Brien MJ1,2,3, Bullard KM4, Zhang Y4, Gregg EW4, Carnethon MR5, Kandula NR6,7,5, Ackermann RT6,7 

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Last Updated on April 19, 2018 by Marie Benz MD FAAD