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USPSTF 2022: Insufficient evidence of benefit vs harm of screening for type 2 diabetes in children and adolescents (I statement)
Clinical Question
What are the benefits and harms of screening for prediabetes and type 2 diabetes in children and adolescents?
Bottom line
Don't pull out another sharp needle. The USPSTF concludes the evidence is insufficient to assess the balance of benefits and harms of screening for prediabetes and type 2 diabetes in asymptomatic children and adolescents (nonpregnant), regardless of risk factors (I statement). This is the first time the task force has reviewed this topic. 5
Reference
Study design: Practice guideline
Funding: Government
Setting: Various (guideline)
Synopsis
The incidence of obesity, prediabetes/glucose intolerance, and type 2 diabetes in children and adolescents younger than 18 years continues to rise every year. This first-time US Preventive Services Task Force (USPSTF) review of the available evidence found that screening asymptomatic children and adolescents can identify those with an elevated blood glucose and/or hemoglobin A1c level. However, there is no high-quality evidence that treatment with lifestyle intervention and/or medication reduces adverse health outcomes. There are no direct studies comparing screening with no screening, but similar long-term randomized trials have found no benefit of screening for reducing adverse health outcomes in adults. No direct evidence of harm from screening was detected, but labeling children and adolescents with a "disease" has previously been shown to result in an increased parental perception of child vulnerability to illness or injury, which is the central construct of the "vulnerable child syndrome".
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
Diabetes screening in obese kids
I think screening for diabetes IS indicated in obese kids. A needle stick is not that traumatic. Childhood obesity is a massive problem. In one generation we went from kids playing outside all the time to kids sitting in front of a video game console. What can be done to change this?