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April 28, 2021updated 04 May 2021 4:06pm

Proposed lowering of diabetes screening age may drive increase in US cases

Diabetes affects approximately 34.1 million Americans and is the seventh-highest cause of death in the US. Type 2 diabetes (T2D) is the predominant form, accounting for 90%-95% of all diabetes cases.

By GlobalData Healthcare

Diabetes affects approximately 34.1 million Americans and is the seventh-highest cause of death in the US. Type 2 diabetes (T2D) is the predominant form, accounting for 90%-95% of all diabetes cases.

The US Preventive Services Task Force (USPSTF) has proposed new guidelines for the screening of T2D. If they are accepted, GlobalData epidemiologists expect that the new eligibility criteria will likely drive an increase in the diagnosed prevalent cases of T2D.

The guidelines, which were last updated in 2015, would lower the screening age of overweight or obese adults from 40 years to 35 years, up until age 70. In addition, the new guidelines would recommend screening for prediabetes, which occurs when an individual’s blood sugar level is elevated but not high enough to diagnose diabetes. This draft proposal follows an increasing body of evidence that suggests a rising risk in prediabetes and diabetes in younger individuals. According to the February 2020 Morbidity and Mortality Weekly Report (MMWR) published by the Centers for Disease Control and Prevention (CDC), new cases of diabetes in those under 20 years of age increased between 2002 and 2015, with a 4.8% annual increase in T2D and a 1.9% annual increase in type 1 diabetes.

In the US, GlobalData epidemiologists forecast the number of diagnosed prevalent cases of T2D to be approximately 22.3 million cases in 2021, and expect this to grow to about 25 million cases in 2028 (as shown in Figure 1). However, if these new guidelines take effect, the number of diagnosed cases will likely surpass the current forecasts as a result of increased case identification. The expanded screening criteria will help capture more of the potentially at-risk population by initiating screening sooner, resulting in earlier disease detection and improved patient outcomes. The public comment period on the draft recommendation closed April 12, and the guidelines are being reviewed prior to the release of the final recommendation.

GlobalData epidemiologists suggest that a further analysis of the surveillance data should occur over the next five years to more clearly assess, characterize, and quantify the impact of these new guidelines.

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