Population screening for Type 2 diabetes leads to survival benefit
MedWire News: Results from a population-based cohort study suggest that individuals who are screened for Type 2 diabetes have lower long-term mortality than those who are not.
Simon Griffin (Institute of Metabolic Science, Cambridge, UK) and colleagues assessed the impact on long-term mortality of inviting 1705 of 4936 patients from a single practice in Ely, Cambridgeshire, UK to Type 2 diabetes screening.
The initial screening took place in 1990-1992 when the participants were aged 40-65 years. They had an oral glucose tolerance test and related cardiovascular risk factors such as lipids and blood pressure were also measured.
A further 1705 individuals from the rest of the cohort were selected for screening in 2000-2003, leaving 1526 who were not screened. All participants were followed-up for mortality until January 2008.
In total, 345 deaths occurred from 1990-1999 and 291 from 2000-2008. Individuals invited to the first round of screening had a nonsignificant 21% reduction in all-cause mortality at study completion in 2008 versus those who did not undergo screening. However, no mortality difference was observed between invited and noninvited participants for the second screened group in 2008.
The researchers note that only 68% and 45% of those invited to the first and second screening sessions, respectively, actually attended. When this was taken into account, participants who attended either diabetes screening session had significantly lower (46-48% decrease) and those who were invited but did not attend had significantly higher (36-73% increase) mortality than those who were not screened.
"While results from this analysis are promising, it remains unclear whether early detection and treatment of diabetes and related cardiovascular disease risk factors is beneficial and produces sufficient improvement in long-term health outcomes to justify the economic costs," write the authors in the journal Diabetologia.
"In view of the extensive organizational, technical, and financial input that a national Type 2 diabetes screening program would demand, evidence of the cost effectiveness of screening from prospective randomized controlled trials prior to implementation would be desirable."
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By Helen Albert