Summary

A computer model has been used to see whether it is cost effective to screen for diabetes or its precursor, impaired glucose tolerance. The findings say that, yes, it is a worthwhile investment, but we need to know more about the impact of the early detection of diabetes.

Introduction

Although type 2 diabetes is on the increase and its health consequences can be very serious, there is no program for screening for it in the UK. This means that there are many patients with diabetes who do not know they have the condition. because it often has no obvious symptoms until complications like heart disease set in. Type 2 diabetes is usually preceded by impaired glucose tolerance, which can be readily detected by a simple blood test. So maybe it would be worthwhile screening people for impaired glucose tolerance so they can adopt lifestyle measures to ward off type 2 diabetes. Previous research has suggested that this may be so. But widespread screening is costly for health services. Therefore, researchers at the University of Leicester, UK, used a computer analysis to determine whether it would be worthwhile going down the screening route for type 2 diabetes.

What was done

The researchers applied a computer model to a hypothetical population aged 45 or more who had an above average risk of diabetes. They used clinical trial and epidemiology data and also Department of Health statistics for England and Wales.

What was found

Screening costs money, especially if it is accompanied by prescription of medication, in the short term. But the upside is years of life gained through either preventing diabetes or ameliorating its damage by catching it early. The researchers' figures showed that screening for both impaired glucose tolerance and type 2 diabetes, with appropriate interventions, appeared to be cost-effective in the long-term.

What this study means

it is a worthwhile investment for the health service to pay more attention to the earliest signs of type 2 diabetes. This means testing people with risk factors like high blood pressure or high cholesterol for their glucose tolerance. They then stand a better chance, it they increase physical activity, change their diet or take medication, of preventing type 2 diabetes or of avoiding the complications of the condition.