Diabetes Screening & Early Detection
Diabetes is a rapidly accelerating public health crisis demanding immediate policy attention. Early detection of diabetes is important, as timely and adequate diabetes management could prevent or delay complications, comorbidity, poor quality of life and premature death, as such contributing substantially to decreasing the burden of diabetes for individuals, health systems and societies.
See the sections below and read the article 'The Case for Diabetes Screening and Early Detection' for more details.
Type 1 diabetes
Type 1 diabetes (T1D) is the most common chronic disease in children and adolescents. The European Region has the highest number of children and adolescents living with T1D (295,000) as well as the highest incidence annually with 31,000 new cases per year. The incidence of T1D is increasing in Europe by more than 3% per year.
A large proportion of people with T1D are diagnosed under dramatic circumstances in the emergency rooms, presenting with abnormally high blood sugars and a dangerous, sometimes fatal, condition called diabetes ketoacidosis (DKA). Detecting T1D before symptoms occur is possible through a simple blood test. Screening for T1D would provide people the time to prepare for the diagnosis, develop a plan for further monitoring with their doctor and avoid serious adverse events and hospitalization.
Type 2 diabetes
Given the silent and progressive nature of Type 2 Diabetes (T2D), early detection and prompt diagnosis are critical to avoid long-term complications such as heart diseases, kidney diseases and eye disease. Not only are these complications potentially overwhelming from a personal perspective, but they are also hugely costly to health systems.
Screening people for diabetes and diabetes-related complications will help ensure that the relevant action is undertaken early (e.g., initiation of education and treatment) thereby delaying, or reducing the risk of developing, the condition and/ or its complications. While the investment in upfront screening and risk-reduction campaigns might be significant, the case for the cost-effectiveness of prevention has been clearly demonstrated.
Furthermore, targeted screening for type 2 diabetes may be considered, in particular among adults with overweight, obesity, high blood pressure, high cholesterol, or other relevant risk factors. Screening of people at high risk of developing diabetes should be integrated with high blood pressure and hypercholesterolemia screening programs within primary care. Selective screening for diabetes and prediabetes is also recommended for patients with established cardiovascular disease.
Gestational diabetes places an increased risk for the mother and the child to develop T2D and / or T1D later on in life. Detection of women with hyperglycaemia during pregnancy is crucial as they have a higher risk of developing adverse pregnancy outcomes and neonatal problems. Follow-ups of mothers and babies must also be included in all risk-reduction strategies.
In many countries screening for gestational diabetes among pregnant women has been implemented based on guidelines. These guidelines differ according to screening approaches and criteria for gestational diabetes, which results in various screening practices across and within EU countries. To improve the quality and outcomes of gestational screening, guidelines may need to be updated and aligned, and good practices could be exchanged.