Sunday, June 8, 2008

Health Update - Routine Blood Sugar Testing no Longer Recommended

According to new recommendations, there is little to be gained from routine screening for Type 2 diabetes. The exception is hypertensive patients without diabetes symptoms, and blood pressure readings 135/80 or higher. "Direct evidence is lacking on the health benefits of detecting type 2 diabetes by either targeted or mass screening, and indirect evidence also fails to demonstrate health benefits for screening general populations”, says the US Preventive Services Task Force (USPSTF). The report is published in the June 3 issue of the Annals of Internal Medicine.

The impetus for the review was to determine the risks and benefits for routinely screening adults for Type 2 diabetes at the doctor’s office, and to update guidelines from 2003. To determine the best practice, the reviewers looked at data from the Cochrane Review and Medline for studies and observations that would tell them a little more about outcomes of pre-diabetic and diabetic treatments in patients who had the condition for less than a year. Patients with high blood pressure and diabetes have a 10-year risk of developing cardiovascular disease, making routine screening more valuable. Testing decisions should still be determined on an individual basis by your family doctor, with consideration for your overall risk factors.

Estimates show that 26% of adults already have abnormal fasting glucose levels and impaired glucose tolerance. Despite the estimates, the benefits of early detection and treatment remain unclear. We don’t know enough about how well diabetics respond to early aggressive treatment. Evidence is inconclusive that cholesterol-lowering medications will prevent diabetic complications. The authors feel that screening everyone will lead to wider use of potentially harmful medications.

High blood pressure and diabetes co-exist, so you might expect your doctor to perform a test for diabetes type 2 if your blood pressure is 130/85 or higher. Speak with your doctor if you think you have symptoms of diabetes. Excessive thirst, frequent urination and excessive hunger are the three most common symptoms. Given the updated guidelines, it’s likely that insurance companies will no longer pay for glucose testing during your annual office visit, unless there's a good reason.