No impact on death rates from diabetes screening, study finds

Picture: Greg Macvean
Picture: Greg Macvean
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Screening for type 2 ­diabetes does not reduce death rates, a groundbreaking British study has concluded.

It found no evidence that screening had any impact on mortality rates of people diagnosed with the illness, which usually starts in adulthood and has been linked to poor diet.

The study assessed the number of deaths over ten years in a group of more than 20,000 patients across 32 GP surgeries in the UK. The people were all aged between 40 and 69 and were at high risk of contracting diabetes.

They divided into three groups – one where screening was followed up by routine care for those diagnosed with diabetes, a second where screening was followed by intensive management of the illness and a control group where no screening took place.

Death rates were not reduced in any of the groups, despite screening and aftercare.

The study also found no significant difference between the screened and non-screened groups in the number of deaths linked to diabetes, cardiovascular illness and cancer.

Study leader Dr Simon Griffin, of the epidemiology unit at Addenbrooke’s Hospital in Cambridge, said: “In the large UK sample we studied, screening for 
type 2 diabetes in patients at increased risk of the disease was not associated with any reduction in mortality within ten years.

“It seems that the benefits of screening might be smaller than expected and restricted to ­individuals with detectable ­disease.

“However, benefits to the population could be increased by including the detection and management of cardiovascular risk factors alongside the assessment of diabetes risk, performing repeated rounds of ­screening and improving strategies to maximise screening uptake.”

Commenting in The Lancet medical journal, Michael Engelgau of America’s Centres for Disease Control and Prevention in Atlanta, said the findings questioned the need for wide-scale screening for diabetes.

He said: “This study increases doubt about the value of wide-scale screening for undiagnosed diabetes alone and deserves credit for tackling the screening quandary head-on. Screening recommendations are, therefore, likely to be country specific and context-specific for the ­foreseeable future.”

Previous studies have found people living in deprived communities are 60 per cent more likely to have type 2 diabetes – a condition which can be reversed by improved diet – compared to the most affluent areas.

A programme, Keep Well Scotland, has been set up to target people living in poorer areas to identify high risk patients and offer them health advice to reduce rates of the illness and better manage their health problems.

Barbara Young, chief executive of Diabetes UK, said: “This study demonstrates diabetes healthcare in the areas where the participants lived is not good enough.”

Around 200,000 people in Scotland have type 2 diabetes – which develops when the body does not produce enough insulin to maintain a normal blood glucose level, or when the body is unable to effectively use the insulin being produced.