Population Screening for Diabetes Mellitus

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Abstract
The role and value of screening for diabetes mellitus is still unclear. If asymptomatic subjects are to be screened, then a fasting plasma glucose > 6.6 mmol 1−1 or a venous plasma glucose 2 h after a 75 g oral glucose load > 8.0 mmol 1−1 or the presence of any glucose in a urine sample passed 2 h after a main meal should be regarded as a positive result. A fasting plasma glucose in the range 5.5–6.6 mmol 1−1 is an equivocal result which should lead to retesting in 6–12 months if there is any risk factor for diabetes (obesity, family history of diabetes, Asian/African racial origin). Other screening tests or combinations of tests are not recommended. Screening should be restricted to subjects between 40 and 75 years and should be undertaken only every 5 years (3 years if a risk factor for diabetes is present), ideally in parallel with other health screening initiatives. No diagnosis should be made or treatment begun on the basis of a single screening test; subjects with a positive result should have further investigations as necessary to reach a diagnosis in line with WHO criteria.

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