Performance of the 2015 US Preventive Services Task Force Screening Criteria for Prediabetes and Undiagnosed Diabetes

O’Brien, Matthew J.; Bullard, Kai McKeever; Zhang, Yan; Gregg, Edward W.; Carnethon, Mercedes R.; Kandula, Namratha R.; Ackermann, Ronald T.

doi:10.1007/s11606-018-4436-4

Cited by 11 publications

(8 citation statements)

References 36 publications

(34 reference statements)

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“…Further, in a similar investigation, 66% of respondents met the American Diabetes Association's diabetes screening criteria; however, only 46.2% reported receiving any form of screening such that 3.7% were classified as having undiagnosed type 2 diabetes and 36.3% were classified as having undiagnosed prediabetes [29]. O'Brien et al [30] revealed only half of American adults with dysglycemia would be identified following USPSTF screening criteria and that more rigorous diabetes risk factors should be included in screening efforts to promote early detection and intervention in high-risk groups.…”

Section: Discussionmentioning

confidence: 92%

Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults

Mahoney

Bradley

Pitts

et al. 2020

IJERPH

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Over a third of adults in the United States have prediabetes, and many of those with prediabetes will progress to type 2 diabetes within 3–5 years. Health insurance status may factor into a proper diagnosis of prediabetes and diabetes. This study sought to determine the associations between health insurance and undiagnosed prediabetes and diabetes in a national sample of American adults. Publicly available data from 13,029 adults aged 18–64 years from the 2005–2016 waves of the National Health and Nutrition Examination Survey were analyzed. Health insurance type (Medicaid, Private, Other, None) was self-reported. Prediabetes and diabetes status were assessed with measures of self-report, glycohemoglobin, fasting plasma glucose, and two-hour glucose. Covariate-adjusted logistic models were used for the analyses. Overall, 5976 (45.8%) participants had undiagnosed prediabetes, while 897 (6.8%) had undiagnosed diabetes. Having health insurance was associated with decreased odds ratios for undiagnosed prediabetes: 0.87 (95% confidence interval (CI: 0.79, 0.95)) for private insurance, 0.84 (CI: 0.73, 0.95) for other insurance, and 0.78 (CI: 0.67, 0.90) for Medicaid. Moreover, having private health insurance was associated with 0.82 (CI: 0.67, 0.99) decreased odds for undiagnosed diabetes. Health insurance coverage and screening opportunities for uninsured individuals may reduce prediabetes and diabetes misclassifications.

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Section: Discussionmentioning

confidence: 92%

Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults

Mahoney

Bradley

Pitts

et al. 2020

IJERPH

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“…This is consistent with the study by O’Brien, et al, which found a positive predictive value for the USPSTF limited criteria of 62% (95% CI 57.8-66.1). 7 This suggests that the high rate of diabetes and prediabetes is not due to clinicians selecting high risk patients for screening, but rather is the true prevalence in the population and clinicians are potentially missing diagnoses for patients who were eligible but not screened. In addition, clinicians missed the diagnoses for 7363 patients, 32.9% of those who were screened.…”

Section: Discussionmentioning

confidence: 99%

“…3 Screening based on this criteria has been found to have a sensitivity of 47.3% and a specificity of 71.4%. 7 This study excluded those with previously diagnosed diabetes or who were pregnant during the study period. Participants with a history of prediabetes were included if they met criteria for diabetes screening.…”

Section: Methodsmentioning

confidence: 99%

Factors Associated with Clinician Adherence to USPSTF Diabetes Screening Recommendations

Banerjee

Shaak

Burgess

et al. 2021

J Prim Care Community Health

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Introduction/Objectives: Diabetes and prediabetes impact nearly half of the US adult population and are associated with significant health risks but may be underdiagnosed. Effective screening may improve diagnosis and give patients opportunity to manage their disease. The purpose of this study was to determine screening rates, identify characteristics predictive of screening, and evaluate correct diagnosis of diabetes and prediabetes. Methods: Retrospective chart review of 71 433 patients eligible for diabetes screening, defined by completing A1c test within the 3-year study period. Results: A total of 31.3% of eligible patients received diabetes screening. Factors associated with screening include older age, female sex, non-white race, Hispanic ethnicity, Medicare or Medicaid insurance, higher BMI, and having a medical comorbidity. History of prediabetes or gestational diabetes were the strongest predictors for diabetes screening, but history of gestational diabetes was under-documented. Of those screened, 10.4% had a result consistent with diabetes and 51.8% had a result consistent with prediabetes. However, 52.9% of these patients had a missed diagnosis. Conclusions: Findings of this study indicate the need for uniform coverage for diabetes screening for all insurances, increased documentation of gestational diabetes to improve screening for patients with this history, and improving accurate diagnosis after screening is completed.

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“…The United States Preventive Services Task Force (USPSTF) recommends screening for abnormal blood glucose in adults aged 40–70 years with overweight or obesity [12]. A study of the performance of the USPSTF recommendations revealed that only half of the individuals with undiagnosed dysglycaemia were detected, and substantially less in racial/ethnic minorities [13]. The Canadian primary care system, which screens its patients as early as 40 years of age, found that useful in detecting unrecognised diabetes.…”

Section: Screeningmentioning

confidence: 99%

Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus – 2020

Alawadi

Abusnana

Afandi

et al. 2020

Dubai Diabetes Endocrinol J

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Rapid urbanisation and socioeconomic development in the United Arab Emirates (UAE) have led to the widespread adoption of a sedentary lifestyle and Westernised diet in the local population and consequently a high prevalence of obesity and diabetes. In 2019, International Diabetes Federation statistics reported a diabetes prevalence rate of 16.3% for the adult population in the UAE. In view of the wealth of recent literature on diabetes care and new pharmacotherapeutics, the Emirates Diabetes Society convened a panel of experts to update existing local guidelines with international management recommendations. The goal is to improve the standard of care for people with diabetes through increased awareness of these management practices among healthcare providers licensed by national health authorities. These consensus guidelines address the screening, diagnosis and management of type 2 diabetes mellitus in adults including individuals at risk of developing the disease.

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Performance of the 2015 US Preventive Services Task Force Screening Criteria for Prediabetes and Undiagnosed Diabetes

Abstract: Diabetes screening that follows the limited USPSTF criteria will identify approximately half of US adults with dysglycemia. Screening other high-risk subgroups defined in the USPSTF recommendation would improve detection of dysglycemia and may reduce associated racial/ethnic disparities.

Cited by 11 publications

References 36 publications

Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults

Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults

Factors Associated with Clinician Adherence to USPSTF Diabetes Screening Recommendations

Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus – 2020

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