Is there a case to undertake population screening for diabetes in the UK? Introduction Diabetes has been known since at least 1552 B.C.E. (Canadian Diabetes Association, 2011), although modern insulin therapy, as required for Type 1 Diabetes, did not begin until 1922…
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Any of these could lead eventually to the need for extreme measures such as amputation as described by the Diabetes and Hormone Center for the Pacific (undated). These problems not only cause untold suffering, but of course are expensive in that long term care is required for sufferers of the many complications that can ensue, any or all of which might well have been prevented. Diabetes UK has for some years been asking for the establishment of an active screening programme which would identify those with Type 2 diabetes at an early stage, in order to ensure that the person involved receives the most appropriate future care.( June 2006) In 2010 the group estimated the number of undiagnosed cases within the United Kingdom to be 1 million or more. Type 1 Diabetes Type I Diabetes usually presents in young people, often in a quite abrupt way, with weight loss and attacks of hyperglycemia, possibly after a viral illness. The body stops producing insulin. The condition is relatively uncommon, covering only 10% of those with diabetes, and does not have a long latent stage, according to Norman (1997), so would not fit into a national screening programme. ...
It therefore makes sense to have a nationwide screening programme in place. However Engalou et al (2000) point out that screening a whole population is uneconomic due to low levels of diabetes in the general population. They suggest that screening sections of the population known to be prone to the condition, such as those with a close family history of the disease, would be an effective use of resources. In the general population this would mean aiming screening at obese older people, especially those with a close family history of diabetes , and including those with a BMI of 25-30kg/m2 and over. Diabetes UK ( 2006, page 4) give details of waist measurements in various racial types which require further investigation, as well as naming a number of associated conditions such as peripheral vascular disease. As Simmons and Voyle pointed out in 2003 particular racial groups world wide may be particularly vulnerable. The American Agency for Healthcare Research and Quality in 2001 found that diabetes was more prevalent in black people at 10.8%, whereas in the white population it was at the lower level of 6.2%. Asians in the UK have a high risk of developing the condition with the percentage running at 20% in those over 40. (Greenhalgh, 1997 ). In 2009 de Hert stated ( page 3) that diabetes is three times more prevalent in those with severe schizophrenia than in the general European population. Such people should therefore be screened for the condition, even if apparently symptomless. . In the United Kingdom Diabetes UK report (June 2006) that only 60% of the UK has definite programmes in place to identify diabetes at an early stage. Effective Screening According to a WHO paper (2003),
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