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Jonas DE, Crotty K, Yun JDY, et al. Screening for Prediabetes and Type 2 Diabetes Mellitus: An Evidence Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Aug. (Evidence Synthesis, No. 207.)
Screening for Prediabetes and Type 2 Diabetes Mellitus: An Evidence Review for the U.S. Preventive Services Task Force [Internet].
Show detailsTable 4Main Results of Studies Evaluating Screening for Diabetes That Reported Health Outcomes (KQ 1)*
|
Author, Year Trial Name Diagnosis of DM, No. |
Mortality G1 vs. G2; HR (95% CI) |
CVD Events G1 vs. G2; OR, or RR, (95% CI) |
Quality of Life G1 vs. G2 |
|---|---|---|---|
|
Echouffo-Tcheugui, 201536 ADDITION-Cambridge, 7-year followup G1: 466 G2: NR | NR |
7 years CVD events (MI or stroke), self-reported: 142 (12.4%) vs. 67 (13.5%), OR, 0.90 (0.71 to 1.15) |
SF-8 physical health summary score,† mean (SD): 47.8 (9.8) vs. 47.8 (10.3). Beta‡ −0.33 (95% CI, −1.80 to 1.14) SF-8 mental health summary score,† mean (SD): 51.8 (8.6) vs. 52.2 (8.1). Beta‡ −0.38 (95% CI, −1.33 to 0.57) EQ-5D score,† mean (SD): 0.87 (0.16) vs. 0.87 (0.15). Beta‡ 0.002 (95% CI, −0.02 to 0.02) EuroQol visual acuity score,† mean (SD): 74.5 (16.5) vs. 73.7 (17.2). Beta‡ 0.80 (95% CI, −1.28 to 2.87) |
|
Rahman, 201238 Ely, diabetic subgroup Total: 199 G1: 116 (108 screen detected) G2: 83 (26 screen detected). |
G1: 0 G2: 0 Evaluation was limited to those diagnosed with diabetes who attended health assessment |
Self-reported MI: 7/92 vs. 8/60, p=0.29; RR, 0.57 (0.22 to 1.49) Self-reported stroke: 3/92 vs. 5/60, p=0.19; RR, 0.39 (0.10 to 1.58) Clinical ischemic heart disease:‖ 18/92 vs. 8/60, p=0.32 ECG-confirmed ischemic heart disease:¶ 30/92 vs. 28/60, p=0.11; RR, 0.70 (0.47 to 1.04) Peripheral vascular disease:# 5/92 vs. 2/60, p=0.55; RR, 1.63 (0.33 to 8.13) |
Mean SF-36§ physical function score: 67.2 (SD, 29.4) vs. 69.6 (SD 30.7); p=0.64 Mean SF-36 mental health score: 77.8 (SD, 16.5) vs. 79.7 (SD, 16.1); p=0.47 Mean EQ-5D visual analog scale (95% CI): 78 (65 to 85) vs. 79.5 (60 to 88), p=0.68 |
|
Rahman, 201239 Ely, nondiabetic subgroup G1: 0 G2: 0 |
G1: 0 G2: 0 Evaluation was limited to those not diagnosed with diabetes who attended health assessment |
Self-reported MI: 28/731 vs. 29/711, p=0.9 Self-reported stroke: 13/731 vs. 12/711, p=0.7 Clinical ischemic heart disease:‖ 78/731 vs. 53/711, p=0.2 |
Median (IQR) SF-36** physical function score: 90 (75-95) vs. 90 (75-95); p=0.4 Median (IQR) SF-36 mental health score: 84 (68-92) vs. 84 (68-92); p=0.8 Mean EQ-5D visual analog scale (95% CI): 78.3 (77.2 to 79.4) vs. 77.7 (76.5 to 79.0), p=0.9 |
|
Simmons 201235 ADDITION-Cambridge G1: 466 G2: NR |
10 years All-cause mortality: 1,532 vs. 377; 1.06 (0.90 to 1.25)†† Cardiovascular mortality: 482 vs. 124; 1.02 (0.75 to 1.38) Cancer mortality: 697 vs. 169; 1.08 (0.90 to 1.30) Other mortality: 353 vs. 84; 1.10 (0.87 to 1.39) Diabetes-related mortality: 75 vs. 16; 1.26 (0.75 to 2.10) | NR | NR |
|
Simmons, 201137 Ely G1: 51, 26, and 31 in first, second, and third rounds of screening, respectively G2: NR |
Phase 1: 345 total deaths from 1991 to 1999, median 10-year followup (47,854 person-years) All-cause mortality: 116 vs. 229, 0.96 (0.77 to 1.20); adjusted‡‡ 0.79 (0.63 to 1.00)§§ Cancer-related mortality: 52 vs. 107; CVD mortality 41 vs. 74; other mortality 23 vs. 48 Phase 2: 291 total deaths from 2000 to 2008, median 8.1 y (23,144 person-years) All-cause mortality: 165 vs. 126, 1.20 (0.95 to 1.51); adjusted‡‡ 1.18 (0.93 to 1.51)§§ Cancer-related mortality 44 vs. 47; CVD mortality 68 vs. 43; other mortality 53 vs. 36 | NR | NR |
- *
None of the included studies reported on amputations, skin ulcers, visual impairment, or periodontitis.
- †
SF-8 scale ranges from 0 to 100 for each summary score.
- ‡
Beta coefficients represent the mean difference between groups.
- §
Medical Outcomes Study Short Form Health Survey, scale 0-100. Higher scores indicate better function.
- ‖
Based on Rose angina questionnaire score >3.
- ¶
Defined by Minnesota coding of ECG.
- #
Defined as ABPI <0.9, for which the article reports 90% sensitivity and specificity among in symptomatic disease. The article did not report whether any of these persons had symptoms of PVD.
- **
Medical Outcomes Study Short Form Health Survey, scale 0-100. Higher scores indicate better function.
- ††
Among G1 (the screening group), nonattenders had higher all-cause mortality than attenders: HR 2.01 (1.74 to 2.32) and were younger, more obese, more likely to be men, and less likely to be taking antihypertensive medications.
- ‡‡
Adjusted for age, sex, and deprivation (determined using the Townsend Index, which was calculated using postcodes to determine material deprivation based on four factors derived from the 1991 UK census: unemployment, overcrowding, car ownership, and home ownership).
- §§
For phase 1, comparing those who attended screening vs. controls (G1-a vs. G2), the HR for all-cause mortality was 0.64 (0.47 to 0.86) and the adjusted HR was 0.54 (0.40 to 0.74). Comparing those who did not attend screening vs. controls (G1-b vs. G2), the HR for all-cause mortality was 1.68 (1.27 to 2.22) and the adjusted HR was 1.36 (1.01 to 1.82). For phase 2, comparing those who attended screening vs. controls (G1-a vs. G2), the HR for all-cause mortality was 0.46 (0.31 to 0.69) and the adjusted HR was 0.52 (0.35 to 0.78). Comparing those who did not attend screening vs. controls (G1-b vs. G2), the HR for all-cause mortality was 1.85 (1.45 to 2.36) and the adjusted HR 1.73 (1.34 to 2.24).
Abbreviations: ABPI=Ankle-brachial pressure index; ADDITION=Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care; CI=confidence interval; CVD=cardiovascular disease; DM=diabetes mellitus; ECG=electrocardiogram; EQ-5D=EuroQol Research Foundation and LimeSurvey; G=group; HR=hazard ratio; IQR=interquartile range; KQ=key question; MI=myocardial infarction; No.=number; NR=not reported; OR=odds ratio; PVD=peripheral vascular disease; RR=relative risk; SD=standard deviation; SF-8=Short Form-8 questionnaire; SF-36=Short Form-36 questionnaire; U.K.=United Kingdom; vs.=versus.
- Table 4, Main Results of Studies Evaluating Screening for Diabetes That Reported...Table 4, Main Results of Studies Evaluating Screening for Diabetes That Reported Health Outcomes (KQ 1)* - Screening for Prediabetes and Type 2 Diabetes Mellitus: An Evidence Review for the U.S. Preventive Services Task Force
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