Screening for Type 2 Diabetes > Population at Risk Author: Lorraine Lipscombe, MD, FRCPC; Denice S. Feig, MD, MSc, FRCPC
Editorial changes - 2009-05-01
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Key Points
Population at Risk
Effectiveness/Harms of Screening Tests
Effectiveness/Harms of Early Treatment
Direct Evidence that Screening Reduces Adverse Outcomes
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Note that the risk of diabetes significantly increases with increasing obesity, with the greatest risk in persons with abdominal fat accumulation.B

Evidence:

  • Based on a survey of over 195,000 U.S. adults, the adjusted odds ratio of self-reported diabetes was 1.59 (1.46 to 1.73) in overweight (BMI 25 to 29.9 kg/m2) persons, 3.44 (3.17 to 3.74) in moderately obese (BMI 30 to 39.9 kg/m2) persons, and 7.37 (6.39 to 8.50) in the severely obese (BMI >=40 kg/m2). This association was consistent across sexes, races, educational levels, and smoking status (16).
  • In a German cohort study of 5953 persons aged 35 to 74 years, the age-adjusted hazard ratio for incident diabetes doubled for every 4 kg/m2 increase in BMI above normal (<25 kg/m2) (17).
  • The risk of type 2 diabetes is greatest in persons with central or abdominal fat accumulation, a marker of insulin resistance and the metabolic syndrome. Increased waist circumference and waist-to-hip ratio are associated with an increase in diabetes incidence (RR 2 to 5), even after adjusting for BMI (18; 19; 20).

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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