Screening for diabetes.

The prevalence of type 2 diabetes is rapidly increasing. A strong rationale exists for identifying asymptomatic individuals who are at high risk or are likely to have diabetes. Screening programs may provide a conduit through which diabetes intervention may be targeted towards those who might benefit most. Diabetes screening could lessen disease burden in two ways. Firstly, by identifying people with undiagnosed diabetes, the burden of diabetes complications could be lessened through appropriate management of the condition. Secondly, by indentifying people at high risk of developing diabetes, and entering these people into diabetes prevention programs, the number of people with diabetes could be reduced. Screening for diabetes should ideally involve a non-invasive risk assessment followed by blood testing for those found to be at high risk. It should be noted that conclusive randomised controlled trial data to support the long-term health and economic impact of screening programs is lacking. The answers surrounding who and how we should screen for diabetes and the associated long term benefits will continue to evolve as the evidence base builds. As the use of screening for diabetes builds in popularity, it is essential that health care systems are sufficiently equipped to effectively manage the newly identified high risk and prevalent cases of type 2 diabetes.