Screening all adults aged 35 to 70 years, regardless of weight, identifies the greatest proportion of adults with prediabetes and diabetes, according to a study published online March 24 in the American Journal of Preventive Medicine.
Matthew J. O’Brien, M.D., from the Feinberg School of Medicine at Northwestern University in Chicago, and colleagues examined the clinical performance of U.S. Preventive Services Task Force diabetes screening recommendations (2015 and 2021), as well as alternative age and body mass index (BMI) cutoffs in the U.S. adult population overall and separately by race and ethnicity. The analysis included data from 3,243 nonpregnant adults without diagnosed diabetes (January 2017 to March 2020).
The researchers found that the 2021 criteria (versus the 2015 criteria) exhibited marginally higher sensitivity (58.6 versus 52.9 percent) and lower specificity (69.3 versus 76.4 percent) overall and within each racial and ethnic group. Even greater sensitivity and lower specificity was seen for screening at lower age and BMI thresholds, especially among Hispanic, non-Hispanic Black, and Asian adults. The most equitable performance across all racial and ethnic groups was seen for screening all adults (ages 35 to 70 years) regardless of BMI.
“Diabetes is a condition in which unacceptable racial and ethnic disparities persist,” O’Brien said in a statement. “That’s why we need a screening approach that maximizes equity. If we can find everyone earlier, it helps us reduce these disparities and the bad outcomes that follow.”
