The Controversy Of Pre-Testing

The Controversy Of Pre-Testing: Many primary care physicians have suggested that patients 45 years of age and older receive Type 2 diabetic screenings every three years so the disease can be treated more effectively in its earliest stages.

However, a 2008 report from Annals of Internal Medicine indicates a diabetic screening may not be needed. This report suggests detecting hypertension may be a much better indicator of the presence of diabetes. According to that report, “The U.S. Preventive Services Task Force (USPSTF) revised guidelines recommend[ing] that doctors screen for type 2 diabetes only in adults with sustained high blood pressure above 135 over 80 millimeters mercury (mm Hg).”

The scientific community may be at odds over the effective early diagnosis for diabetes. Many physicians still support regular diabetic screenings, but this newer information is based on additional studies. The report stated, “Intensive lifestyle modification in persons with pre-diabetes delays the progression to full-blown diabetes, but whether treatment alters final health outcomes could not be determined from the studies reviewed.”

What this research tends to suggest is that early treatment of diabetes or even pre-diabetes may have some positive effect it may not significantly alter the final progression of the disease. The role suggested is one of monitoring blood pressure as an indicator of the potential presence of diabetes. This would reduce the diabetic testing of many individuals and may reduce health care costs until such time as diabetes has been diagnosed using the more streamlined blood pressure testing as a pre-test for the disease.


Dr. Susan L. Norris told Reuters Health, “Aggressive lifestyle changes can dramatically reduce the incidence of diabetes, but it is not clear whether the diagnosis of pre-diabetes confers any particular health benefit over and above what one might expect if all obese patients were counseled to pursue these lifestyle changes.”

Norris seems to suggest that individuals should pursue positive lifestyle choices even without a diagnosis of pre-diabetes. If individuals committed to health goals that included a balanced diet, physical exercise and stress reduction they would already be pushing the potential of diabetes further away.

Perhaps the point of this report is that wise choices over a long period of time can result in a better health picture overall. The potential reduction in testing would likely result in significant health savings for patients and allow simple blood pressure checks to alert health care providers to the potential onset of diabetes. Admittedly blood pressure checks can be self administered at many pharmacies and are routine checks when visiting your doctor.

Included in their report the U.S. Preventive Services Task Force stated,  “Screening for type 2 diabetes provides few benefits.” As previously stated their singular exception was for those suffering with hypertension.

There is also the potential that excessive focus on the disease might result in excessive patient stress regarding its potential impact. The end result may be a low cost and low stress method of monitoring the potential without making it a proverbial dragon to be faced with fear and trembling.

The American Diabetes Association indicates 7.4% of Americans have diabetes. The U.S. Preventive Services Task Force seems to be indicating it may not be necessary to subject the other 92.6% to regular tests.

While some may argue the validity of testing this does provide room for discussion with your doctor when you have questions about the potential for diabetes.