“Screen and treat” policies to preventing type 2 diabetes are unlikely to have substantial impact on this growing epidemic, concludes an Oxford-led study published by The BMJ today.
These findings suggest that 'screen and treat' policies alone are unlikely to have substantial impact on the worsening epidemic of Type 2 diabetes.
There are two approaches to prevention: screen and treat, in which people are identified as “high risk” and offered individual intervention, and a population-wide approach, in which everyone is targeted via public health policies. The UK’s National Diabetes Prevention Programme follows Australia and the United States in placing the emphasis on a screen and treat approach.
So a team of researchers, led by Professor Trish Greenhalgh from Oxford University's Nuffield Department of Primary Care Health Sciences at the University of Oxford, assessed the diagnostic accuracy of screening tests for pre-diabetes (high risk of developing type 2 diabetes in the future) and effectiveness of interventions in preventing onset of type 2 diabetes in people with pre-diabetes.
They conclude that “screen and treat” policies will benefit some but not all people at high risk of developing diabetes, and they should be complemented by population-wide approaches for effective diabetes prevention.
He points out that “pre-diabetes” is an unsatisfactory term because many people so labelled do not develop diabetes, and believes there is a balance to be struck between the medical model of screening and treating of individuals of individuals, and the public health model of changing behaviour in the whole population at risk.