New USPSTF Guidelines May Miss Half of Patients with Dysglycemia
Diabetes screening criteria from the US Preventive Services Task Force (USPSTF) could miss nearly half of dysglycemia cases, according to the results of a recent study.
In October 2015, the USPSTF issued new prediabetes and diabetes screening guidelines for adults aged 40 to 70 years who are overweight and obese. But with the increasing prevalence of dysglycemia in younger individuals and those with lower body weight, researchers hypothesized that the screening criteria may fail to identify certain high-risk subgroups.
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For their study, the researchers conducted a retrospective analysis of electronic health records from 50,515 adults. Individuals with dysglycemia at baseline and those with fewer than 2 office visits during follow-up were excluded.
At baseline, 18,846 were aged 40 years or older, 33,537 were overweight or obese, and 39,061 were of a racial or ethnic minority.
Overall, 29,946 of the patients had a glycemic test and 8478 patients developed dysglycemia during follow-up. Only 12,679 (25.1%) of the patients were eligible for screening under the USPSTF criteria, demonstrating a sensitivity of 45% and a specificity of 72% for detecting dysglycemia. Individuals of racial or ethnic minorities were significantly less likely to be eligible for screening but had higher odds of developing dysglycemia than white individuals.
“Primary care providers may miss a substantial proportion of patients with dysglycemia by following the current USPSTF screening recommendation,” the authors wrote. “Providers may consider screening patients from racial/ethnic minority groups before the age and weight ranges recommended by the USPSTF. However, patients may incur out-of-pocket costs when their doctors obtain a diabetes screening test that does not follow the USPSTF recommendation.”
O’Brien MJ, Lee JY, Carnethon MR, et al. Detecting dysglycemia using the 2015 United States Preventive Services Task Force screening criteria: a cohort analysis of community health center patients [published online July 12, 2016]. PLoS Med. doi: http://dx.doi.org/10.1371/journal.pmed.1002074.