MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.
Diabetes Obes Metab. 2010 Oct;12(10):838-44. doi: 10.1111/j.1463-1326.2010.01244.x.
A growing body of evidence on diabetes screening has been published during the last 10 years. Type 2 diabetes meets many but not all of the criteria for screening. Concerns about potential harms of screening have largely been resolved. Screening identifies a high-risk population with the potential to gain from widely available interventions. However, in spite of the findings of modelling studies, the size of the benefit of earlier initiation of treatment and the overall cost-effectiveness remains uncertain, in contrast to other screening programmes (such as for abdominal aortic aneurysms) that are yet to be fully implemented. There is also uncertainty about optimal specifications and implementation of a screening programme, and further work to complete concerning development and delivery of individual- and population-level preventive strategies. While there is growing evidence of the net benefit of earlier detection of individuals with prevalent but undiagnosed diabetes, there remains limited justification for a policy of universal population-based screening for type 2 diabetes at the present time. Data from ongoing studies should inform the key assumptions in existing modelling studies and further reduce uncertainty.
在过去的 10 年中，已经发表了大量关于糖尿病筛查的证据。2 型糖尿病符合许多但不是所有的筛查标准。关于筛查潜在危害的担忧已基本得到解决。筛查可以识别出高危人群，他们有可能从广泛可用的干预措施中获益。然而，尽管模型研究的结果表明，早期开始治疗的收益大小和总体成本效益仍然不确定，这与其他尚未全面实施的筛查计划（如腹主动脉瘤筛查）形成了鲜明对比。对于筛查计划的最佳规范和实施，以及进一步完成个人和人群层面预防策略的制定和实施，仍然存在不确定性。虽然有越来越多的证据表明早期发现患有普遍但未确诊的糖尿病的个体具有净收益，但目前还没有充分的理由对 2 型糖尿病进行全民普查。正在进行的研究的数据应该为现有模型研究中的关键假设提供信息，并进一步减少不确定性。
