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Overweight and obese Americans should start screening earlier, at age 35 instead of 40, according to updated national guidelines released Tuesday.
The new advice stems from rising rates of obesity and type 2 diabetes, and research showing the health benefits of prevention methods and early treatment. Three in four American adults are overweight or obese, which increases their chances of developing diabetes.
Among adults 18 and older, 14 percent are already diagnosed with diabetes and 33 percent have prediabetes. Screening is recommended up to age 70.
The advice from the US Task Force on Preventive Services, an advisory group to the US government, has been published online in the Journal of the American Medical Association. It updates the 2015 task force recommendations and says even earlier screening should be considered for overweight or obese American Indians, blacks, Hispanics and other groups with rates of diabetes. disproportionately high.
The American Diabetes Association says overweight or obese adults of any age should be screened.
Screening means blood tests to measure blood sugar and sometimes involves drinking a sweet liquid first. The new guidelines suggest that people with normal tests could be screened every three years.
Type 2 diabetes impairs the body’s ability to use insulin to regulate blood sugar, resulting in high levels that can cause heart problems, organ damage and blindness. Prediabetes means higher than normal blood sugar levels which can lead to full-blown diabetes.
The incidence of type 2 diabetes has increased in recent years, along with obesity rates. A 2001-17 report in the same journal shows that the rate nearly doubled among children aged 10 to 19, from 34 cases per 100,000 children to 67 per 100,000.
Guidelines from the task force indicate that evidence shows that diet and physical activity can prevent or delay diabetes in adults with prediabetes. The diabetes drug metformin has been shown to do the same, but has not been approved for this use, the task force notes. The drug is not without risk and some doctors oppose its use in this way, noting that two-thirds of people with prediabetes never develop the disease.
A JAMA editorial says evidence shows that few American adults with prediabetes are referred to diabetes prevention or weight loss programs that could help them avoid diabetes and its complications. He calls for a wider range of effective prevention programs, covered by insurance and accessible to those who need them most.
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