Do people who have Diabetes Mellitus Type 2 detected by screening tests do better than people who have Diabetes discovered when they present with symptoms? Conventional wisdom says screening detects Diabetes earlier and patients should have better outcomes. A study which compared people detected by screening vs people who had their diabetes detected when presenting with symptoms does not support this. Screening was based on family history of diabetes, a personal history of heart disease or gestational diabetes, obesity, hypertension, or high cholesterol. All patients were given similar treatment after detection. At baseline, patients presenting with symptoms had higher sugars and A1Cs while the people presenting for screening had more cardiovascular disease, kidney disease, and higher blood pressure. No difference in endpoints was noted, leading the authors to recommend more studies to validate these findings and possibly recommend against screening. DSK comments. I have provided the source for this study so you can see for yourself. My interpretation of the study invalidates any results as the people were chosen to be screened based on the presence of cardiovascular risk factors, ie obesity, hypertension, high cholesterol or heart disease. While they had the advantage having the Diabetes treatment start in an earlier stage of the disease,the benefit was cancelled out by pre-selecting people with a higher risk of heart disease. When setting up a study to answer a specific question, the populations at baseline should not be so different. I would have preferred a study in which people were selected for screening at random, and then offered the same standard of treatment as the people presenting with symptoms. What do you think? Please comment below.
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