Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus
Authors: Ebrahim Barkoudah, Larry A. Weinrauch
Journal: Annals of Internal Medicine (2016)

Letters2 August 2016Screening for Abnormal Blood Glucose and Type 2 Diabetes MellitusEbrahim Barkoudah, MD, MPH and Larry A. Weinrauch, MDEbrahim Barkoudah, MD, MPHFrom Brigham and Women's Hospital and Harvard Medical School, Boston, and E.P. Joslin Research Laboratory, Boston, Massachusetts.Search for more papers by this author and Larry A. Weinrauch, MDFrom Brigham and Women's Hospital and Harvard Medical School, Boston, and E.P. Joslin Research Laboratory, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0100 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the U.S. Preventive Services Task Force's recommendation on screening asymptomatic adults in primary care settings for diabetes (1). Although the focus on hard events in clinical trials is understandable and appropriate, the authors do not fully examine why they discounted morbid events when producing this guideline. Focusing on all-cause mortality in patients at low risk for death and for a short time is insufficient to draw conclusions when mortality rates are low (2). Therefore, a finding of clinical equipoise may represent a statistical error because the studies are underpowered to define a difference ...References1. Siu AL; U.S. Preventive Services Task Force. Screening for abnormal blood glucose and type 2 diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163:861-8. [PMID: 26501513]. doi:10.7326/M15-2345 LinkGoogle Scholar2. Barkoudah E, Skali H, Uno H, Solomon SD, Pfeffer MA. Mortality rates in trials of subjects with type 2 diabetes. J Am Heart Assoc. 2012;1:8-15. [PMID: 23130114] doi:10.1161/JAHA.111.000059 CrossrefMedlineGoogle Scholar3. Kahn R, Alperin P, Eddy D, Borch-Johnsen K, Buse J, Feigelman J, et al. Age at initiation and frequency of screening to detect type 2 diabetes: a cost-effectiveness analysis. Lancet. 2010;375:1365-74. [PMID: 20356621] doi:10.1016/S0140-6736(09)62162-0 CrossrefMedlineGoogle Scholar4. Centers for Disease Control and Prevention. Diabetes public health resource. 2015. Accessed at www.cdc.gov/diabetes/statistics/prevalence_national.htm on 17 November 2015. Google Scholar5. Hillier TA, Pedula KL. Complications in young adults with early-onset type 2 diabetes: losing the relative protection of youth. Diabetes Care. 2003;26:2999-3005. [PMID: 14578230] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital and Harvard Medical School, Boston, and E.P. Joslin Research Laboratory, Boston, Massachusetts.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L16-0100. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement Albert L. Siu and Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus Albert L. Siu Metrics 2 August 2016Volume 165, Issue 3Page: 225KeywordsAdultsDisclosureGlucoseHeart failureHospitalizationsMortalityMyocardial infarctionPopulation statisticsType 2 diabetesVisual impairments ePublished: 2 August 2016 Issue Published: 2 August 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...