The Guideline Guys - Type 2 Diabetes - Part 1
Joe Weatherly MD and Andrew Buelt MD
Taken from ADA, ACP, AAFP, USPSTF and Diabetes Canada guidelines/recommendations
Take Home Points:
- Appropriate screening can reduce of screening harms
- Lifestyle changes are an effective intervention in managing Type 2 DM
- Random blood glucose and risk calculators are the easiest, fastest tests for screening but also the most inaccurate
See chart below.
Risk calculator tools are not as accurate as a blood test but can be used as well in unique situations particularly in uninsured patients to help discuss value of screening with blood sampling.
Who to Screen
- Screening those with multiple risk factors yields the most benefit.
- Pediatric patients with risk factors should be screened but guidelines cannot agree on how often or when to start.
- Depression and bipolar disorder increase risk of developing diabetes.
- Most guidelines recommend screening individuals with hypertension up to 70 years of age.
- Early diagnosis and intervention in Type 2 Diabetes has not proven to improve some outcomes.
- Understanding weaknesses of the test you use can help interpret potentially inaccurate results.
FINDRISC (Finnish Diabetes Risk Score)