Screening for Diabetes and Prediabetes Should Be Cost-Saving in Patients at High Risk

• DOI: 10.2337/dc12-1752
• Publication Date: 2013-02-08T09:23:58Z
• Authors: Ranee Chatterjee; K.M. Venkat Narayan; Joseph Lipscomb; Sandra L. Jackson; Qi Long; Ming Zhu; Lawrence S. Phillips
• Keywords: Prediabetes; Glucose tolerance test; Impaired fasting glucose

OBJECTIVE Although screening for diabetes and prediabetes is recommended, it not clear how best or whom to screen. We therefore compared the economics of according baseline risk. RESEARCH DESIGN AND METHODS Five tests were performed in 1,573 adults without known diabetes—random plasma/capillary glucose, glucose 1 h after 50-g oral (any time, previous fast, plasma a challenge [GCTpl]/capillary [GCTcap]), A1C—and definitive 75-g tolerance test. Costs included following: costs testing (screen plus test, if screen positive); false-negative results; treatment true-positive results with metformin, all over course 3 years. no screening, everyone high-risk prediabetes, those risk factors based on age, BMI, blood pressure, waist circumference, lipids, family history diabetes. RESULTS Compared cost-savings would be obtained largely from at higher risk, including BMI >35 kg/m2, systolic pressure ≥130 mmHg, age >55 years, differences up −46% health system −21% dysglycemia110, respectively (all P < 0.01). GCTpl least expensive test most groups this population CONCLUSIONS From perspective, should target patients particularly can cost-saving. generally considered routine use as an opportunistic these groups.