Test characteristics are enhanced when applied to high risk populations, namely native Canadians, obese individuals and those with a strong family history of diabetes. Based on some evidence that treatment of overt diabetes may retard micro-vascular complications, a decision to screen in those populations could be considered. Screening pregnant women is discussed in Chapter 2 on Gestational diabetes.
Prevalence increases with age.
Diabetes may cause life threatening metabolic complications and is an important risk factor for other leading causes of death such as coronary heart disease, congestive heart failure and cerebrovascular disease. Individuals with this disease have higher hospitalization rates, longer hospital stays and more ambulatory care visits than persons without diabetes. Type II diabetes generally occurs after age 30. Finally, firm evidence that treatment of individuals with immune markers prevents progression of disease or reduces complications is lacking. There are two gold standard diagnostic criteria for DM depending on the presence or the absence of symptoms.