U.S. Adults Should Begin Diabetes Screening at 35, Medical Panel Recommends

A medical panel recommended that people who are overweight should be screened for prediabetes and Type 2 diabetes starting at age 35, five years earlier than previous advisory.

The U.S. Preventive Services Task Force (USPSTF), an independent group of medical experts that makes evidence-based recommendations for preventive services and screenings, suggested that screening at a younger age could facilitate earlier medical treatment.

The new guideline comes amid rising rates of obesity and diabetes in the United States. Around 13% of U.S. adults have diabetes while 34.5% meet the criteria for prediabetes, according to CDC's 2020 National Diabetes Statistics Report.

More than 40% American adults should now be screened, the task force said.

“If they have overweight or obesity—unfortunately that’s most people living in the country—and if people are discovered to have pre-diabetes, they should be referred for effective preventive interventions, with diet and exercise being the primary ones,” Michael Barry, MD, vice chair of the USPSTF, tells Verywell.

Type 2 diabetes is the most common form of diabetes and it affects how well the body can process sugar (glucose). It can lead to serious complications such as kidney failure, vision loss, limb amputation, and nerve damage.

Prediabetes, a precursor to Type 2 diabetes, is a condition in which blood sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes.

During the COVID-19 pandemic, it's especially important to prevent and treat diabetes, as the condition increases the risk of getting severely ill from COVID-19 infection.

Early Screening

Around 21% of people with diabetes were not aware of or did not report having diabetes, according to the CDC report. Barry says that testing for prediabetes and diabetes early on can allow people to take steps to prevent the development of full diabetes or treat their condition.

Primary care physicians can perform a blood test to screen for diabetes during an annual checkup. The task force said individuals should be screened every three years until age 70 and the recommendation does not apply to pregnant women.

Those with a family history of diabetes or a personal history of conditions like gestational diabetes, should be screened even earlier than age 35. Additionally, certain communities of color that have higher prevalence of diagnosed diabetes should also consider getting screened early.

Though experts don’t expect that earlier screenings will detect significantly more people with developed diabetes, it may help identify more of the estimated 24% of young adults with prediabetes.

Preventing the Onset of Diabetes

A recent study indicates that there has been no substantial improvement in glycemic control and risk factor management for people with diabetes over the last decade.

“Even before COVID-19 presented a new challenge as a common cause of severe morbidity with particularly severe outcomes in the population with diabetes, there was growing evidence that the long-term improvements in diabetes-related complications have slowed in these groups,” Edward Gregg and Tannaz Moin wrote in an editorial accompanying the task force’s recommendation.

People who are diagnosed with prediabetes can make some lifestyle changes to help prevent it from developing into Type 2 diabetes. These include doing at least 150 minutes of physical activity per week, eating a healthier diet, and even losing some weight.

The drug Metaformin can also help manage glucose levels, though it’s not as beneficial to overall health as adopting certain lifestyle changes.

“We've very reasonably focused on the COVID pandemic, given its severity and the number of people who've been affected,” Barry says. “But all those old diseases, like diabetes, are still around. We need to acknowledge that overweight and obesity are an epidemic, and diabetes and pre-diabetes are an epidemic as well.”