About one-third of U.S. adults have high blood sugar levels, a condition called pre-diabetes that often precedes Type 2 diabetes and can progress to full blown disease. Most are unaware they have the condition, which doesn’t produce obvious symptoms and is why screening is essential, Dr. Barry said.
Being overweight or obese is the most important risk factor for the most common type of diabetes, Type 2 diabetes, and for pre-diabetes. Lifestyle changes — including increasing physical activity, eating a healthier diet and losing even a modest amount of weight — can prevent the progression from pre-diabetes to full diabetes. (Drug treatment is also an option.)
Screening generally involves a blood test to determine whether blood sugar (or glucose) is elevated. The task force called for lowering the age of first screening to 35 because that is when the prevalence of Type 2 diabetes starts to inch upward. Screening should be carried out every three years until age 70, the task force said.
Dr. Tannaz Moin, an endocrinologist who co-wrote an editorial accompanying the new recommendations, said that lowering the age for screening was a step in the right direction, and that she was pleased that the guidelines emphasized the importance of detecting pre-diabetes.
“There’s a lot more recognition that pre-diabetes is a big problem that often flies under the radar,” she said. It is critical to detect pre-diabetes in younger adults, because they may live with diabetes for a long time if they develop it at a relatively young age, and will be at a greater risk of developing complications.
Intensive lifestyle interventions that focus on moderate weight loss and include 150 minutes of physical activity per week can prevent or delay the onset of Type 2 diabetes in overweight or obese people with pre-diabetes. A drug, metformin, is also an option but is not as beneficial as lifestyle changes.
“We have really good evidence that we can delay the onset of Type 2 diabetes if we get individuals who have pre-diabetes to do something about their risk,” Dr. Moin said. “It’s the same for people with Type 2 diabetes: Once we know they have it, we have a whole toolbox of things we can offer them.”