Diabetes screening seen to be worth the cost in US

The cost of routinely screening older Americans for type 2 diabetes every three years would be acceptable, researchers report.

"Screening people 45 years of age or older every three years with a blood glucose test is appropriate and affordable," Dr. Susan L. Johnson told AMN Health. "Ideally, such screening should occur as a part of ongoing medical care."

Johnson, at the University of Michigan Health System, Ann Arbor, and colleagues note in the journal Diabetes Care that the direct and indirect cost of diabetes in the US was estimated to be $132 billion in 2002.

Because of this enormous cost and the relative ease with which type 2 diabetes can be detected before symptoms become obvious, the American Diabetes Association has recommended screening in asymptomatic people of 45 years and older.

"Approximately 5.2 million Americans have undiagnosed diabetes," Johnson added.

To estimate the cost of certain screening strategies for monitoring the US population, the researchers simulated screening subjects from 45 to 74 years of age using random blood glucose measurements at intervals of 1, 2 or 3 years.

The estimated cost of screening depended on the cut-off glucose level used and how often the test was done, the team found. The best compromise, the researchers calculated, was 3-yearly testing, at a cost of about $10 billion over 15 years.

While this may seem like a lot, the cost of detecting one undiagnosed case of diabetes when screening is performed every three years during a regular check-up is only $275, the team says.

SOURCE: Diabetes Care, February 2005.