Diabetes Screening

Session leader: Joe DeLuca, MD

Reading:
Harris et al. Screening Adults for Type 2 Diabetes: A review of the evidence for the US Preventive Services Task Force. Ann Intern Med 2003.

Please answer the following questions: [click here for a Word document of these questions]

1. What are the three most important issues in the controversy of whether to screen for diabetes?

2. How prevalent is diabetes? How prevalent is our population?

3. On average, how many years before symptoms of diabetes can be detected?

4. What is the main problem in using HgA1C as a screening test for diabetes?

5. What is the sensitivity of fasting plasma glucose (FPG) versus two-hour post-prandial as the gold standard? What does this mean β€œin plain English?”

6. Assuming a prevalence of diabetes of 5%, what % of patients with random glucose >120 have diabetes?

7. True or False. Evidence suggests that tight glycemic control leading to decrease cardiovascular mortality is one of the major reasons to screen for diabetes?

8. What is the relevance of HTN on the diabetes screening controversy?

9. What are the main potential harms of screening for diabetes?

10. What % of those with impaired glucose tolerance reverts to normal? What % of those with impaired glucose tolerance found through screening will revert to normal?

11. What are the main benefits to screening?

12. (A) What does table 5 indicate?

(B) What is the apparent irony in Table 5 concerning diabetes screening?
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