Diabetes screening guidelines strengthened
All adults should be tested by age 45
June 23, 1997
Web posted at: 11:55 p.m. EDT
From Medical Correspondent Rhonda Rowland
ATLANTA (CNN) -- Of the estimated 16 million people in the
United States with diabetes, about half of them don't know
they have it.
In an effort to improve that situation, new recommendations
have been issued calling for changes in the way diabetes is
detected and diagnosed. The guidelines were developed by an
international panel of experts and have been endorsed by the
National Institutes of Health.
For the first time, all adults are being urged to undergo a
blood test for diabetes by age 45 and have additional tests
every three years thereafter. Previously, only people who
doctors suspected might have diabetes were screened.
"Potentially, there are 1 to 2 million people in the
population who could be diagnosed using this criteria," said
Dr. Richard Eastman of the NIH. "We think that many will be
diagnosed, since it's a relatively easy test to perform on
routine blood work done in a doctor's office."
There's another change being recommended in the arena of
diabetes screening. Previously, a blood sugar reading of 140
or more would result in a diagnosis of diabetes. The new
threshold is 126.
"The problem with the former cutoff of 140 is that by the
time people were diagnosed with diabetes, about 20 percent
already had complications," Eastman says. "We know that the
risk goes up sharply for those complications when the blood
sugar gets to be about 126."
Preventing complications is the impetus behind the new
recommendations. Early diagnosis of diabetes is the key to
preventing eye, heart, kidney and nerve damage that can be
caused by an untreated diabetic condition.
"It's really a pity when the first time we see someone who's
diagnosed as diabetic is when they're having their heart
attack or when they're having a hemorrhage into their eye,"
says Dr. Carol Teutsch, a diabetes specialist.
Once a diagnosis is made, controlling blood sugar starts with
diet and exercise. Some people also will have to take insulin
For those without diabetes, some studies suggest that
exercise and good nutrition may prevent people from
developing the condition. A large study now under way should
provide a definitive answer in three to four years.
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