Predicting Risk for Diabetes: Choosing (or Building) the Right Model
Authors: William H. Herman
Journal: Annals of Internal Medicine (2009)

Editorials2 June 2009Predicting Risk for Diabetes: Choosing (or Building) the Right ModelWilliam H. Herman, MD, MPHWilliam H. Herman, MD, MPHFrom University of Michigan, Ann Arbor, MI 48109.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-11-200906020-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Whether to screen for type 2 diabetes mellitus in asymptomatic adults is controversial (1). No trial has established that systematic screening for diabetes and early treatment improve health outcomes more than treatment after routine clinical diagnosis (2). The U.S. Preventive Services Task Force (USPSTF) recently recommended testing adults for diabetes if they have symptoms of diabetes or evidence of diabetic complications, including vascular disease (2). It also recommended screening adults for diabetes if they have sustained blood pressure greater than 135/80 mm Hg, because lowering blood pressure below conventional target values in patients with diabetes reduces the incidence of cardiovascular ...References1. Engelgau MM, Narayan KM, Herman WH. Screening for type 2 diabetes. Diabetes Care. 2000;23:1563-80. [PMID: 11023153] CrossrefMedlineGoogle Scholar2. U.S. Preventive Services Task Force. Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148:846-54. [PMID: 18519930] LinkGoogle Scholar3. Lauritzen T, Griffin S, Borch-Johnsen K, Wareham NJ, Wolffenbuttel BH, Rutten G; Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care. The ADDITION study: proposed trial of the cost-effectiveness of an intensive multifactorial intervention on morbidity and mortality among people with Type 2 diabetes detected by screening. Int J Obes Relat Metab Disord. 2000;24 Suppl 3 S6-11. [PMID: 11063279] CrossrefMedlineGoogle Scholar4. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20:537-44. [PMID: 9096977] CrossrefMedlineGoogle Scholar5. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al; Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343-50. [PMID: 11333990] CrossrefMedlineGoogle Scholar6. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403. [PMID: 11832527] CrossrefMedlineGoogle Scholar7. Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M; STOP-NIDDM Trial Research Group. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet. 2002;359:2072-7. [PMID: 12086760] CrossrefMedlineGoogle Scholar8. Gerstein HC, Yusuf S, Bosch J, Pogue J, Sheridan P, Dinccag N, et al; DREAM (Diabetes REduction Assessment with ramipril and rosiglitazone Medication) Trial Investigators. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet. 2006;368:1096-105. [PMID: 16997664] CrossrefMedlineGoogle Scholar9. Herman WH, Brandle M, Zhang P, Williamson DF, Matulik MJ, Ratner RE, et al; Diabetes Prevention Program Research Group. 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 Scholar10. Third National Health and Nutrition Examination Survey. Predicting impaired glucose tolerance using common clinical information: data from the Third National Health and Nutrition Examination Survey. Diabetes Care. 2003;26:2058-62. [PMID: 12832313] CrossrefMedlineGoogle Scholar11. Meigs JB, Williams K, Sullivan LM, Hunt KJ, Haffner SM, Stern MP, et al. Using metabolic syndrome traits for efficient detection of impaired glucose tolerance. Diabetes Care. 2004;27:1417-26. [PMID: 15161798] CrossrefMedlineGoogle Scholar12. Colagiuri S, Hussain Z, Zimmet P, Cameron A, Shaw J; AusDiab. Screening for type 2 diabetes and impaired glucose metabolism: the Australian experience. Diabetes Care. 2004;27:367-71. [PMID: 14747215] CrossrefMedlineGoogle Scholar13. Tabaei BP, Engelgau MM, Herman WH. A multivariate logistic regression equation to screen for dysglycaemia: development and validation. Diabet Med. 2005;22:599-605. [PMID: 15842515] CrossrefMedlineGoogle Scholar14. Stern MP, Williams K, Haffner SM. Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Ann Intern Med. 2002;136:575-81. [PMID: 11955025] LinkGoogle Scholar15. Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003;26:725-31. [PMID: 12610029] CrossrefMedlineGoogle Scholar16. Schmidt MI, Duncan BB, Bang H, Pankow JS, Ballantyne CM, Golden SH, et al; The Atherosclerosis Risk in Communities Investigators. Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. Diabetes Care. 2005;28:2013-8. [PMID: 16043747] CrossrefMedlineGoogle Scholar17. Hippisley-Cox J, Coupland C, Robson J, Sheikh A, Brindle P. Predicting risk of type 2 diabetes in England and Wales: prospective derivation and validation of QDScore. BMJ. 2009;338:b880. [PMID: 19297312] CrossrefMedlineGoogle Scholar18. Johnson SL, Tabaei BP, Herman WH. The efficacy and cost of alternative strategies for systematic screening for type 2 diabetes in the U.S. population 45-74 years of age. Diabetes Care. 2005;28:307-11. [PMID: 15677784] CrossrefMedlineGoogle Scholar19. Kahn HS, Cheng YJ, Thompson TJ, Imperatore G, Gregg EW. Two risk-scoring systems for predicting incident diabetes mellitus in U.S. adults age 45 to 64 years. Ann Intern Med. 2009;150:741-51. LinkGoogle Scholar20. Ealovega MW, Tabaei BP, Brandle M, Burke R, Herman WH. Opportunistic screening for diabetes in routine clinical practice. Diabetes Care. 2004;27:9-12. [PMID: 14693958] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Michigan, Ann Arbor, MI 48109.Disclosures: None disclosed.Corresponding Author: William H. Herman, MD, MPH, 1500 East Medical Center Drive, 3920 Taubman Center, Box 5354, Ann Arbor, MI 48109; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTwo Risk-Scoring Systems for Predicting Incident Diabetes Mellitus in U.S. Adults Age 45 to 64 Years Henry S. Kahn , Yiling J. Cheng , Theodore J. Thompson , Giuseppina Imperatore , and Edward W. 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Tehran glucose and lipid studyDevelopment and Validation of a Patient Self-assessment Score for Diabetes RiskHeejung Bang, PhD, Alison M. Edwards, MStat, Andrew S. Bomback, MD, MPH, Christie M. Ballantyne, MD, David Brillon, MD, Mark A. Callahan, MD, Steven M. Teutsch, MD, MPH, Alvin I. Mushlin, MD, ScM, and Lisa M. Kern, MD, MPH 2 June 2009Volume 150, Issue 11Page: 812-814KeywordsComplex systemsDatabasesForecastingGlucoseGlucose intoleranceMedical risk factorsPopulation statisticsSpecificityType 2 diabetes ePublished: 2 June 2009 Issue Published: 2 June 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...