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For adults who are overweight or have obesity, experts now recommend initial screenings for prediabetes and type 2 diabetes be done between ages 35 to 70. Getty Images
  • The United States Preventive Services Task Force recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who are overweight or have obesity.
  • This is a change from their previous recommendation that suggested adults who are overweight or have obesity be screened between the ages of 40 to 70.
  • The goal of earlier screening is to help people avoid developing diabetes and its associated health risks.
  • Prediabetes can be treated with lifestyle changes and sometimes medications.

The United States Preventive Services Task Force, an independent panel of experts in primary care and prevention, announced that they’re revising their recommendations for initial screening for type 2 diabetes and prediabetes for adults who are overweight or have obesity.

The revised recommendation suggests people between the ages of 35 to 70 who are overweight or have obesity should be screened. This has been changed from the previous recommended age range of people 40 to 70 years.

Obesity is the leading risk factor for type 2 diabetes.

They further suggest that patients with prediabetes should be referred to interventions aimed at preventing them from developing type 2 diabetes.

According to Vice-Chairperson Dr. Michael Barry, the task force reviews emerging research and updates their recommendations based on new evidence about every 5 years.

The current update to their recommendations was prompted by new evidence that lowering the age from 40 to 35 could be beneficial to patients.

“If the screening identifies someone as having prediabetes, they can then help prevent the progression to diabetes by making changes to their diet and physical activity,” said Barry.

“This is especially important because diabetes is the seventh leading cause of death in the United States and can result in serious health problems, including heart disease, stroke, and limb amputation.”

Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic who’s not on the task force, added that 1 in 3 Americans have prediabetes, and it’s estimated that 13 percent of adults over the age of 18 have diabetes.

She said the hope is that earlier screening will capture more people with undiagnosed and untreated diabetes. If diabetes is detected earlier, then patients will have better health outcomes and there will be a decreased risk of complications.

Gina L.C. Yosten, PhD, an associate professor of pharmacology and physiology at Saint Louis University and editor-in-chief of the American Journal of Physiology, said that screening for type 2 diabetes is “relatively simple.” Yosten is also not a member of the task force.

“Prediabetes and type 2 diabetes can be diagnosed using blood tests to measure fasting blood sugar levels, as well as HbA1c, which is a way to measure the average blood sugar levels of an individual over the previous several months,” Yosten said.

“Lastly, prediabetes and type 2 diabetes can be diagnosed with an oral glucose tolerance test, which involves consuming a set amount of sugar and then measuring the amount of sugar in the blood 2 hours later.”

Yosten noted that sometimes the tests, in particular the fasting blood sugar test, can be affected by stress or anxiety. It’s important to repeat the tests at least twice before making a final diagnosis, she said.

The National Institute of Diabetes and Digestive and Kidney Diseases states that a fasting blood glucose of 100-125 mg/dL, a 2-hour post 75 g oral glucose challenge of 140-199 mg/dL, or an A1C of 5.7-6.4 percent would be considered prediabetes.

A fasting blood glucose greater than or equal to 126 mg/dL, a 2-hour post 75 g oral glucose challenge greater than or equal to 200 mg/dL, or an A1C greater than or equal to 6.5 percent would lead to a diagnosis of diabetes.

If a screening determines that a person has prediabetes, then there are several steps they could take to prevent the progression to type 2 diabetes.

The American Diabetes Association recommends dietary changes, physical activity, and tobacco cessation as helpful lifestyle modifications to address prediabetes.

Also, drugs like metformin may be given to some patients to help control high blood sugar levels.

In addition, your doctor will look at your cardiovascular disease risk factors — like high blood pressure and high cholesterol — in order to help you reduce your risk for heart disease.

It’s important to work with your doctor to determine what the right treatment plan is for you. Proper treatment may help you avoid developing type 2 diabetes and the potential complications that go along with it.