Screening for Diabetes: Can We Afford Not To Screen?
Authors: David M. Nathan, William H. Herman
Journal: Annals of Internal Medicine (2004)

Editorials4 May 2004Screening for Diabetes: Can We Afford Not To Screen?David M. Nathan, MD and William H. Herman, MD, MPHDavid M. Nathan, MDFrom Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114; and University of Michigan, Ann Arbor, MI 48109. and William H. Herman, MD, MPHFrom Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114; and University of Michigan, Ann Arbor, MI 48109.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-9-200405040-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Chronic degenerative diseases represent the major challenge to public health in the 21st century. Having largely conquered epidemic infectious diseases, we face a future in which such diseases as diabetes and cardiovascular disease, and their underlying risk factors, predominate. Chronic degenerative diseases already cause 70% of deaths worldwide (1). Our medical care system has largely been attuned to the diagnosis and care of acute diseases, which generally cause symptoms and therefore do not require screening. On the other hand, the early stages of chronic degenerative diseases and the risk factors that presage these diseases are often clinically silent and would ...References1. Wild S, Roglic G, Sicree R, Green A, King H. Global burden of diabetes mellitus in the year 2000. Global Burden of Disease. Geneva: World Health Organization; 2003. Google Scholar2. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001;414:782-7. [PMID: 11742409] CrossrefMedlineGoogle Scholar3. Nathan DM. Long-term complications of diabetes mellitus. N Engl J Med. 1993;328:676-85. [PMID: 8487827] CrossrefMedlineGoogle Scholar4. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. 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Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group. BMJ. 1998;317:371-5. [PMID: 9694750] CrossrefMedlineGoogle Scholar18. Herman WH, Brandle M, Zhang P, Williamson DF, Matulik MJ, Ratner RE, et al . Costs associated with the primary prevention of type 2 diabetes mellitus in the diabetes prevention program. Diabetes Care. 2003;26:36-47. [PMID: 12502656] CrossrefMedlineGoogle Scholar19. Collins R, Armitage J, Parish S, Sleigh P, Peto R. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet. 2003;361:2005-16. [PMID: 12814710] CrossrefMedlineGoogle Scholar20. Saaddine JB, Engelgau MM, Beckles GL, Gregg EW, Thompson TJ, Narayan KM. A diabetes report card for the United States: quality of care in the 1990s. Ann Intern Med. 2002;136:565-74. [PMID: 11955024] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114; and University of Michigan, Ann Arbor, MI 48109.Disclosures: None disclosed.Corresponding Author: David M. Nathan, MD, Massachusetts General Hospital Diabetes Center, 50 Staniford Street, Boston, MA 02114; [email protected]org.Current Author Addresses: Dr. Nathan: Massachusetts General Hospital Diabetes Center, 50 Staniford Street, Boston, MA 02114.Dr. Herman: Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI 48109. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Type 2 Diabetes Mellitus: A Cost-Effectiveness Analysis Thomas J. Hoerger , Russell Harris , Katherine A. Hicks , Katrina Donahue , Stephen Sorensen , and Michael Engelgau Metrics Cited ByCardiovascular Prevention: Components, Levels, Early Origins, and MetricsIs prevention a fantasy, or the future of medicine? A panoramic view of recent data, status, and direction in cardiovascular preventionImportance and Benefits of Lifestyles Changes Versus Diabetes Drugs in Effective Management of DiabetesThe effects of a patient-based risk assessment prompt on diabetes screeningDisproportionate Impact Of Diabetes In A Puerto Rican Community Of ChicagoAlteraciones del metabolismo glucídico en la hipertensión arterial esencial. Papel de la sobrecarga oral con glucosa 4 May 2004Volume 140, Issue 9Page: 756-758KeywordsBlood pressureCardiovascular diseasesClinical trialsDyslipidemiaHealth economicsHyperglycemiaHypertensionQuality adjusted life yearsQuality of lifeType 2 diabetes ePublished: 4 May 2004 Issue Published: 4 May 2004 CopyrightCopyright © 2004 by American College of Physicians. 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