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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 or medications.

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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