Overweight Adults to Now Be Screened for Type 2 Diabetes At 35
The U.S. Preventive Services Task Force (USPSTF) lowered its recommended type 2 diabetes screening age for overweight and obese adults. What sat at 40 years of age has now been upped to age 35, replacing USPSTF’s 2015 statement on screening for type 2 diabetes in asymptomatic adults. The change is reflective of evidence published in the Journal of the American Medical Association (JAMA) that signals an increase in prevalence of type 2 diabetes across all age groups and the growing burden of chronic health conditions.
Based on the Centers for Disease Control and Prevention’s 2020 National Diabetes Statistics Report, it is estimated that 13 percent of all U.S. adults have diabetes and 34.5 percent meet the requirements for prediabetes. Recommended screening applies to non-pregnant adults aged 35 to 70 years who are considered overweight or obese.
While the cause of type 2 diabetes is currently unknown, type 2 has often been incorrectly stigmatized and generalized as a disease caused by poor diet and lifestyle. Research has shown that type 2 diabetes is more complex than previously understood. However, there is a strong association between being medically obese or overweight and experiencing type 2 diabetes or prediabetes, according to research and Steve Edelman, MD, professor of medicine at the University of California, San Diego, Veteran Affairs Medical Center.
Edelman points to a research study called the Diabetes Prevention Program Study that studied lifestyle modification, diet and exercise. “The weight loss group is extremely effective at delaying or preventing the onset of type 2 diabetes in those individuals who were at risk,” Edelman says. “Other lifestyle studies clearly show that if you can delay weight loss, you can delay the onset of type 2 diabetes.”
In addition to the research published by JAMA, the National Institute of Diabetes and Digestive and Kidney Diseases also reported a rising prevalence of both type 1 and 2 diabetes. Specifically for type 2, the prevalence among children ages 10 to 19 increased by 95 percent over a 16 year period. This evidence underscores the importance of screening across all ages, as overweight and obesity are the strongest risk factors for developing prediabetes and type 2 diabetes.
“People in their 30s generally think of themselves as really young and really healthy. People need to be aware that now is the time, starting at age 35, to just get a simple screening test for diabetes,” Chien-Wen Tseng, a USPSTF task force member and physician at the University of Hawaii said.
The prevalence of diabetes is also higher among communities of color due to a myriad of social factors, including socioeconomic status, the food environment and the physical environment. Compared with the 7.5 percent of white people living with any type of diabetes, the prevalence is double when looking at the percentage among communities of color: 14.7 percent of American Indian and Alaskan, 9.2 percent of Asian, 12.5 percent of Hispanic/Latino and 11.7 percent of non-Hispanic Black ethnicities live with diabetes. Therefore, screening is recommended at an earlier age for the aforementioned groups or in people who have a family history of diabetes, gestational diabetes, or polycystic ovarian syndrome.
“Prevention is important and the sooner we address obesity, not only in adults over the age of 35, but I would say all ages, the healthier our society will be,” Edelman says.
Screening for prediabetes and type 2 is conducted by measuring fasting plasma glucose, HbA1c levels, or with an oral glucose tolerance test.
The criteria for having type 2 diabetes includes:
- Fasting plasma glucose level of 126 mg/dL
- HbA1c level greater than 6.5 percent
- Two-hour postload blood glucose level of 200 mg/dL
The following levels are consistent with prediabetes:
- Fasting plasma glucose level of 100 to 125 mg/dL
- HbA1c level from 5.7 to 6.4 percent
- Two-hour postload blood glucose level from 140 to 199 mg/dL
Resources For Preventing Type 2 Diabetes
The following are resources for type 2 prevention: