For middle-aged adults at high risk of type 2 diabetes, invitation to screening is not associated with a decrease in mortality, according to a study published online in The Lancet.
Rebecca K. Simmons, PhD, from the MRC Epidemiology Unit in Cambridge, U.K., and colleagues assessed the effect of a population-based stepwise screening program on mortality in a parallel group cluster-randomized trial involving 33 general practices in eastern England.
Fifteen practices were assigned to screening followed by intensive multifactorial treatment for those diagnosed with diabetes; 13 were assigned to screening plus routine care of diabetes; and five practices made up a no-screening control group. A total of 20,184 adults, aged 40 to 69 years, at high risk of prevalence of undiagnosed diabetes constituted the study population.
The researchers found that 94% of the 16,047 high-risk individuals in screening practices were invited for screening, 73% attended, and 3% were diagnosed with diabetes. During a median of 9.6 years of follow-up there were 1,532 deaths in the screening practices and 377 in control practices. Invitation to screening was not associated with a significant reduction in cardiovascular-, cancer-, or diabetes-related mortality.
“In conclusion, invitation to a single round of screening for type 2 diabetes in high-risk individuals in U.K. general practice might benefit the minority with detectable disease but was not associated with a reduction in all-cause or diabetes-related mortality over 10 years,” the authors wrote.