Diabetes Caught Early Saves Lives, Money
Screening for Type 2 Diabetes Starting at Age 30-45 Reduces Deaths, Costly Health Complications
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
- Prevented diabetes-related complications (3-9 events prevented per 1,000
- 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
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
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.