It’s best to start screening for type 2 diabetes before middle age and to repeat screening every few years, according to a Lancet study appearing online.
Using a mathematical model, researchers first simulated a U.S. population of 325,000 nondiabetic 30-year-olds. Then they tested several screening strategies on each cohort member, measuring cost-effectiveness against a control strategy of not testing at all until diabetes symptoms or cardiovascular disease developed.
Active screening strategies ranged from starting at age 60 and then repeating every 3 years to the maximal strategy of starting at 30 with repeats every 6 months.
The best strategy — starting between 30 and 45 with repeats every 3 to 5 years — was the most cost-effective and enabled a diagnosis of diabetes some 6 years earlier than just waiting for symptoms to develop. That strategy would prevent seven myocardial infarctions and add 171 quality-adjusted life-years (QALYs) per 1000 people screened over a 50-year span.
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