How Important is Screening for Diabetes?
Screening for diabetes is not considered cost effective for general population, due to its high cost and the need of involvement of trained healthcare personnel, which are generally in short supply. Checking blood sugar level for the entire population is not feasible and also not cost effective. Checking blood sugar level twice (either fasting and post prandial or approximately 2 hours after meal or 2 hours after 75 grams of glucose consumption) for every person in general population (or the entire population for screening) can not be done.
That is why screening is advisable (if ever done to detect diabetes) only for high risk population, which can be rewarding and is cost effective. Selecting “high risk” group for screening for diabetes is important, because if selected properly it can give rich dividends by detecting diabetes at low cost. Detecting diabetes by screening is easy and further evaluation can be done if diabetes is detected in screening.
The following groups of people can be considered “high risk”:
- Individuals who have family history of diabetes mellitus, especially type2 diabetes, because type2 diabetes is to a great extent genetically mediated.
- Obese individuals with BMI of more than 30. Obesity is defined when BMI is more than 30.
- Women who gains bodyweight more than normal during pregnancy.
- Women who delivers a baby weighing more than 4.5kg or approximately 4 kg in a population with constitutionally small body stature.
- Individuals with atherosclerosis at early age (premature atherosclerosis).
- Individuals of more than 40 years of age, as type2 diabetes (commonest form of diabetes) generally occur in people of over 40.
Screening of diabetes is generally done where incidence and prevalence of diabetes is high in a population. Screening of high risk population can detect large number of diabetics with relatively lesser effort and cost, in compare to screening of general population.
