STUDY: CVD risk is at least doubled among people with undiagnosed diabetes

JOURNAL: Ann Intern Med 2003;138:212-229.

AUTHORS: Dr. Alfred Berg

ABSTRACT: Patients with high blood pressure or high cholesterol levels should be screened for diabetes mellitus type 2.

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COMMENTARY: While screening can detect diabetes in the preclinical, asymptomatic stage, the most beneficial interventions are those that reduce cardiovascular risk.

CVD risk is at least doubled among people with undiagnosed diabetes, and aggressive treatment of hypertension or dyslipidemia reduces morbidity and mortality within 5 years of diagnosis.

Glycemic levels are often only slightly elevated during the preclinical phase, the authors note. The benefit of glycemic control during the ensuing 15 years following diagnosis, or in the presence of impaired fasting glucose and impaired glucose tolerance, "is unknown but probably small" because the risk for severe visual impairment, end stage renal disease or amputation is low during this time.

The task force recommends screening for diabetes in patients with hypertension or lipid abnormalities.