Screening for Type 2 Diabetes > Effectiveness/Harms of Screening Tests Author: Lorraine Lipscombe, MD, FRCPC; Denice S. Feig, MD, MSc, FRCPC
Editorial changes - 2009-05-01
Author information and module status
Key Points
Population at Risk
Effectiveness/Harms of Screening Tests
Effectiveness/Harms of Early Treatment
Direct Evidence that Screening Reduces Adverse Outcomes
Timeline
Cost-Effectiveness
Patient Education
Referral/Consultation
Guidelines
Tables
References
Glossary
What's New
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Recommendation
Recognize that the ADA criterion for diabetes of an FBG of 126 mg/dL (7.0 mmol/L) is more reproducible than the 2-hour PG and has excellent specificity for diagnosing diabetes, but its sensitivity is only approximately 50%.B

Evidence:

  • An FBG >=126 mg/dL (7.0 mmol/L) is associated with an increased prevalence of retinopathy (43; 46; 47).
  • An FBG >=126 mg/dL (7.0 mmol/L) is associated with an increased risk of CAD and all-cause mortality (44).
  • An FBG of >=126 mg/dL (7.0 mmol/L) has a specificity of 96% to 99% to detect a 2-hour PG of >=200 mg/dL (11.1 mmol/L) but is only 31% to 79% sensitive, depending on the population (most studies report sensitivities of approximately 50%) (48; 49; 50; 51; 52; 53; 54; 55; 56; 57; 58; 59; 60).
  • The FBG is more reliable than the 2-hour PG. Intra-individual coefficients of variation when repeated 2 to 6 weeks apart were 16.7% for the 2-hour PG value vs. 6.4% for the FBG (45).

Comments:

  • None.

FAQs
Denice S. Feig, MD, MSc, FRCPC has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Lorraine Lipscombe, MD, FRCPC has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Sonal Singh, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.

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