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Diabetes Caught Early Saves Lives, Money

Screening for Type 2 Diabetes Starting at Age 30-45 Reduces Deaths, Costly Health Complications
By
WebMD Health News
Reviewed by Laura J. Martin, MD

March 29, 2010 -- Early screening for type 2 diabetes not only saves lives, but it could save money in the long run through early intervention.

A new study shows that starting screening for diabetes between the ages of 30 and 45 would prevent a significant number of heart attacks, deaths, and diabetes-related health complications and add years of healthy living for people in the U.S.

“Our analyses suggest that screening for type 2 diabetes is cost-effective when started between the ages of 30 years and 45 years, with screening repeated every 3-5 years," write researcher Richard Khan of the American Diabetes Association and colleagues in The Lancet.

“For example, if screening is started at 30 years of age and repeated every three years, about seven myocardial infarctions [heart attacks] per 1,000 people aged 30 years could be prevented over 50 years," they write. "The same screening strategy can be expected to add about 171 QALYs [quality-adjusted life years] per 1,000 people.”

In the study, researchers used information from a representative sample of the U.S. population to create a simulated population of 325,000 people aged 30 without diabetes and then used a computer model to compare eight diabetes screening methods vs. no screening. The screening methods differed in terms of age at initiation, frequency of screening, and whether patients were visiting their doctor specifically for diabetes screening or as part of a visit to monitor high blood pressure.

In their model, once type 2 diabetes was diagnosed it was treated in the standard manner, and researchers estimated the impact of treatment on the rates of heart attack, stroke, diabetes-related health complications, and additional years of healthy life over the next 50 years. They also compared the cost-effectiveness of each screening method.

The results showed that compared with no diabetes screening, all of the diabetes screening strategies:

  • Reduced the number of heart attacks (3-9 heart attacks prevented per 1,000 people screened)
  • Prevented diabetes-related complications (3-9 events prevented per 1,000 people screening)
  • Added 93-194 additional healthy life years per 1,000 people screened

Most screening strategies prevented diabetes-related deaths (2.5 deaths prevented per 1,000 people screened.)

These diabetes screening methods, however, had little or no effect on preventing strokes.

The analysis showed that five of the diabetes screening methods had costs per additional year of life of about $10,500 or less, making them cost-effective for widespread use.

Researchers found screening for diabetes in combination with other standard screening tests, such as high blood pressure and cholesterol, was most cost-effective.

In an editorial that accompanies the study, Guy Rutten of University Medical Center Utrecht in the Netherlands says the study "provides further evidence that screening for diabetes should be combined with screening for hypertension and lipid tests.” Rutten says the recommendation is also in line with the current guideline for screening from the American Diabetes Association.

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