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Overweight Or Not, You Could Still Be At Risk For Diabetes: Experts Suggests A New Method To Measure Health

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Type 2 diabetes and prediabetes affect nearly half of all adults in the United States, posing a significant public health issue. Alarmingly, 81% of adults with prediabetes are unaware that they have the condition, while 23% of diabetes cases remain undiagnosed. Moreover, up to 70% of individuals with prediabetes will eventually progress to diabetes.

It may seem counterintuitive as we typically associate diabetes with being overweight or obese. However, if screening decisions are based solely on weight, individuals from racial and ethnic minority groups who are developing prediabetes and diabetes at lower weights may be overlooked.

According to a recent study from Northwestern Medicine, using age as a screening tool is more effective than relying on weight when identifying individuals with prediabetes and diabetes. Age was found to capture a larger percentage of adults with these conditions, regardless of race or ethnicity. Therefore, the study recommends that healthcare providers prioritize age as a screening factor for prediabetes and diabetes.

A study conducted by Northwestern investigators has determined that screening all adults between the ages of 35 and 70, regardless of their weight, is the most effective way to identify the largest proportion of individuals with prediabetes and diabetes in the United States.

This approach was found to be particularly beneficial in diagnosing prediabetes and diabetes across all racial and ethnic groups. Therefore, the study recommends that healthcare providers adopt this age-based screening strategy to optimize the identification of individuals with these conditions.

“All major racial and ethnic minority groups develop diabetes at lower weights than white adults, and it’s most pronounced for Asian Americans,” remarks lead investigator Dr. Matthew O’Brien.

The findings were just published in the American Journal of Preventive Medicine.

“It might sound counterintuitive because we think of being overweight or obese as the primary cause of diabetes,” O’Brien adds.

At present, the U.S. Preventive Services Task Force (USPSTF) advises screening individuals aged 35 to 70 years who are obese or overweight.

“But if we make decisions about diabetes testing based on weight, we will miss some people from racial and ethnic minority groups who are developing prediabetes and diabetes at lower weights,” O’Brien warns.

Compared to their white counterparts, adults from racial and ethnic minority groups often experience delayed diagnosis of diabetes. This delay can lead to poorer disease control and a higher likelihood of developing complications in the heart, eyes, and kidneys, as well as an increased risk of mortality.

”Diabetes is a condition in which unacceptable racial and ethnic disparities persist,” O’Brien adds. “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.”

Type 2 diabetes and prediabetes affect nearly half of all adults in the United States, posing a significant public health issue. Alarmingly, 81% of adults with prediabetes are unaware that they have the condition, while 23% of diabetes cases remain undiagnosed. Moreover, up to 70% of individuals with prediabetes will eventually progress to diabetes.

According to a recent study, Asian American adults are at risk of developing diabetes and prediabetes even at a normal weight, making them the racial group most likely to be excluded from the latest guidelines for screening prediabetes and diabetes. The study estimates that around 6 million Asian Americans are affected by prediabetes or undiagnosed diabetes.

The study by Northwestern investigators is the first to investigate the health-equity implications of current screening recommendations. They evaluated the clinical effectiveness of the 2021 USPSTF prediabetes and diabetes screening recommendation, as well as alternative age and Body Mass Index (BMI) thresholds. The study examined the effectiveness of the screening recommendation in the entire adult population of the United States, as well as separately by race and ethnicity.

Although the Task Force suggested that healthcare providers consider screening individuals from racial and ethnic groups with a high risk of diabetes at younger ages or lower BMI, these alternatives were not officially included in their recommendation. However, the new study evaluated various options for earlier screening, providing valuable evidence that can help guide future revisions to the Task Force’s guidelines.

“It’s imperative that we identify a screening approach that is equitable across the entire U.S. population,” O’Brien adds. “Our findings illustrate that screening all adults aged 35 to 70 years, regardless of weight or body mass index, performs equitably across all racial and ethnic groups.”

Numerous studies have shown that only a small proportion of eligible adults, often less than 50%, are screened for prediabetes and diabetes.

According to O’Brien, basing screening decisions solely on age is also more straightforward for healthcare providers to implement, which could lead to increased adoption of this approach to screening.

“There are many ways to nudge patients and providers to complete this testing, which should be the focus of future research.”

Image Credit: Getty

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