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Type 2 diabetes screening may reduce CVD and mortality

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Screening for type 2 diabetes followed by early treatment could result in substantial health benefits, according to a team of UK and US researchers.

The study, published in Diabetes Care, found screening followed by treatment led to a reduced risk of cardiovascular disease or death within a five-year follow-up period, compared to no screening.

Researchers from the University of Michigan and the University of Cambridge used data from the ADDITION-Europe study, which they combined with computer simulation of diabetes progression.

“Early identification of diabetes has major health benefits, and supports the introduction of measures such as screening”

William Herman

The ADDITION-Europe study enrolled people 40-69 years of age without known diabetes from 343 general practices in the UK, Denmark, and the Netherlands.

At 10 years after baseline, the simulations predicted that with a delay of three years in diagnosis and treatment, 22.4% of those with type 2 diabetes would experience a CVD event. This rose to 25.9% with a diagnosis delay of six years.

However, if screening and routine care had been implemented, the simulation predicted only 18.4% would experience a CVD event at 10 years after baseline. The simulated incidence of all-cause mortality was 16.4% with a delay of three years and 18.2% with a delay of six years, compared to 14.6% for screening and treatment.

As a result, over 10 years, the model predicts that for people with undiagnosed type 2 diabetes, screening would be associated with a 29% reduction in relative risk of a CVD event, compared with a delay of six years in diagnosis and treatment.

“Half of all people with diabetes are already showing signs of complications by the time they are diagnosed”

Simon O’Neill

This amounts to a 7.5% reduction in the absolute risk of adverse CVD outcome in this population. The comparable change in all-cause mortality was 20% relative risk and 3.6% absolute risk reduction.

Lead author Professor William Herman said: “This research shows that the early identification of diabetes has major health benefits, and supports the introduction of measures such as screening to reduce the time between development of type 2 diabetes and its treatment.”

Simon O’Neill, director of health intelligence at Diabetes UK, said: “Half of all people with diabetes are already showing signs of complications by the time they are diagnosed. 

“This is why we want to see an NHS health check offered to everyone who is eligible,” he said.

“This programme has the potential to find the 630,000 people who have type 2 diabetes but don’t know it, and can help to ensure that they are given a prompt diagnosis and get the treatment they need to reduce their risk of complications,” he added.

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