Diabetes type 2 is
largely becoming common around the world. This has created a huge burden on the
Timely detection and
treatment of diabetes can significantly lower the risk for complications
associated with diabetes.
The screening benefits
of diabetes type 2 are yet to be determined.
Dr. Rebecca K. Simmons
et al conducted a population-based study to determine the effect of stepwise
screening for diabetes type 2 on mortality. The study was published in The
The scientists carried
out a randomized trial and enrolled 33 general medical practices in East
England in three groups- a control group with no screening, second with
screening followed by routine care and third with screening followed by
intensive diabetes care.
The study involved
20184 patients aged between 40 and 69 years and with high risk of diabetes.
tracked the rate of mortality over an average period of 9.6 years.
Dr. Rebecca discovered
that overall mortality did not reduce in groups where screening was done. No
major variation in the number of deaths occurring due to cardiovascular
diseases, diabetes, or cancer, was found in screened and non-screened diabetic
Dr. SImmon Griffin of
the MRC Epidemiology Unit at Addenbrooke's Hospital in Cambridge, UK, said, "It
seems that the benefits of screening might be smaller than expected and
restricted to individuals with detectable disease. However, benefits to the
population could be increased by including the detection and management of
cardiovascular risk factors alongside the assessment of diabetes risk,
performing repeated rounds of screening, and improving strategies to maximise
the uptake of screening."
The main limitation of
the study was the lack of generalization as the study was conducted in
above-average affluent region, where disease threat was quite low as compared
to other socioeconomic regions.
believed that nations with high occurrence of undiagnosed diabetes and poor
quality of life might experience better benefits from screening of
Rury Holman, FRCP, the
Director of the Diabetes Trials Unit and Professor of Diabetic Medicine at
Oxford University, United Kingdom mentioned, "The question they were
asking in this study was if you take the trouble and expense to find people and
declare they are at risk of diabetes and test, and then the community — the
healthcare system — presumably treats them, you think they would do better. But
in the time scale of this study, that wasn't the case. It doesn't mean that you
couldn't find them and put them in a special program, but if you put them into
the normal health care system with an earlier label of diabetes than they would
otherwise have, it doesn't bring any clinical advantages. [The study] says that
the incremental benefit of finding people a few years earlier is quite
highlighted that diabetes type 2 screening was not related with decrease in
cardiovascular or diabetes-linked mortality within 10 years. Screening benefits
can be less than expected and can vary from person to person.
Screening for type 2 diabetes and population
mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled
trial; Rebecca Simmons et al; The Lancet 2012