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. 2020 May 29;5(5):CD005266.
doi: 10.1002/14651858.CD005266.pub2.

Screening for type 2 diabetes mellitus

Nasheeta Peer  1 , Yusentha Balakrishna  2 , Solange Durao  3
Affiliations

Screening for type 2 diabetes mellitus

Nasheeta Peer et al. Cochrane Database Syst Rev. .

Abstract

Background: Diabetes mellitus, a metabolic disorder characterised by hyperglycaemia and associated with a heavy burden of microvascular and macrovascular complications, frequently remains undiagnosed. Screening of apparently healthy individuals may lead to early detection and treatment of type 2 diabetes mellitus and may prevent or delay the development of related complications.

Objectives: To assess the effects of screening for type 2 diabetes mellitus.

Search methods: We searched CENTRAL, MEDLINE, LILACS, the WHO ICTRP, and ClinicalTrials.gov from inception. The date of the last search was May 2019 for all databases. We applied no language restrictions.

Selection criteria: We included randomised controlled trials involving adults and children without known diabetes mellitus, conducted over at least three months, that assessed the effect of diabetes screening (mass, targeted, or opportunistic) compared to no diabetes screening.

Data collection and analysis: Two review authors independently screened titles and abstracts for potential relevance and reviewed the full-texts of potentially relevant studies, extracted data, and carried out 'Risk of bias' assessment using the Cochrane 'Risk of bias' tool. We assessed the overall certainty of the evidence using the GRADE approach.

Main results: We screened 4651 titles and abstracts identified by the search and assessed 92 full-texts/records for inclusion. We included one cluster-randomised trial, the ADDITION-Cambridge study, which involved 20,184 participants from 33 general practices in Eastern England and assessed the effects of inviting versus not inviting high-risk individuals to screening for diabetes. The diabetes risk score was used to identify high-risk individuals; it comprised variables relating to age, sex, body mass index, and the use of prescribed steroid and anti-hypertensive medication. Twenty-seven practices were randomised to the screening group (11,737 participants actually attending screening) and 5 practices to the no-screening group (4137 participants). In both groups, 36% of participants were women; the average age of participants was 58.2 years in the screening group and 57.9 years in the no-screening group. Almost half of participants in both groups were on antihypertensive medication. The findings from the first phase of this study indicate that screening compared to no screening for type 2 diabetes did not show a clear difference in all-cause mortality (hazard ratio (HR) 1.06, 95% confidence interval (CI) 0.90 to 1.25, low-certainty evidence). Screening compared to no screening for type 2 diabetes mellitus showed an HR of 1.26, 95% CI 0.75 to 2.12 (low-certainty evidence) for diabetes-related mortality (based on whether diabetes was reported as a cause of death on the death certificate). Diabetes-related morbidity and health-related quality of life were only reported in a subsample and did not show a substantial difference between the screening intervention and control. The included study did not report on adverse events, incidence of type 2 diabetes, glycosylated haemoglobin A1c (HbA1c), and socioeconomic effects.

Authors' conclusions: We are uncertain about the effects of screening for type 2 diabetes on all-cause mortality and diabetes-related mortality. Evidence was available from one study only. We are therefore unable to draw any firm conclusions relating to the health outcomes of early type 2 diabetes mellitus screening. Furthermore, the included study did not assess all of the outcomes prespecified in the review (diabetes-related morbidity, incidence of type 2 diabetes, health-related quality of life, adverse events, socioeconomic effects).

Trial registration: ClinicalTrials.gov NCT00318032.

PubMed Disclaimer

Conflict of interest statement

NP: none known.

YB: none known.

SD: none known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies (blank cells indicate that the particular outcome was not measured in the included study).
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study (blank cells indicate that the particular outcome was not measured in the included study).
1.1
1.1. Analysis
Comparison 1: Screening for diabetes versus no screening for diabetes, Outcome 1: All‐cause mortality
1.2
1.2. Analysis
Comparison 1: Screening for diabetes versus no screening for diabetes, Outcome 2: Diabetes‐related mortality
1.3
1.3. Analysis
Comparison 1: Screening for diabetes versus no screening for diabetes, Outcome 3: Cardiovascular mortality
1.4
1.4. Analysis
Comparison 1: Screening for diabetes versus no screening for diabetes, Outcome 4: Cancer mortality
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD005266

References

References to studies included in this review

Simmons 2012 {published data only}
    1. Echouffo-Tcheugui JB, Simmons RK, Prevost AT, Williams KM, Kinmonth AL, Wareham NJ, et al. Long-term effect of population screening for diabetes on cardiovascular morbidity, self-rated health, and health behavior. Annals of Family Medicine 2015;13(2):149-57. [PMID: ] - PMC - PubMed
    1. Echouffo-Tcheugui JB, Simmons RK, Williams KM, Barling RS, Prevost AT, Kinmonth AL, et al. The ADDITION-Cambridge trial protocol: a cluster-randomised controlled trial of screening for type 2 diabetes and intensive treatment for screen-detected patients. BMC Public Health 2009;9:136. [PMID: ] - PMC - PubMed
    1. Griffin S. A single screening for type 2 diabetes in high-risk adults did not reduce mortality over 10 years. Annals of Internal Medicine 2013;158:JC4. - PubMed
    1. Sandbaek A, Griffin SJ, Rutten G, Davies M, Stolk R, Khunti K, et al. Stepwise screening for diabetes identifies people with high but modifiable coronary heart disease risk. The ADDITION study. Diabetologia 2008;51(7):1127-34. [PMID: ] - PMC - PubMed
    1. Simmons RK, Borch-Johnsen K, Lauritzen T, Rutten GE, Sandbaek A, den Donk M, et al. A randomised trial of the effect and cost-effectiveness of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with screen-detected type 2 diabetes: the Anglo-Danish-Dutch study of intensive treatment in people with screen-detected diabetes in primary care (ADDITION-Europe) study. Health Technology Assessment (Winchester, England) 2016;20(64):1-86. [PMID: ] - PMC - PubMed

References to studies excluded from this review

Acosta 2018 {published data only}
    1. Acosta T, Barengo NC, Arrieta A, Ricaurte C, Tuomilehto JO. A demonstration area for type 2 diabetes prevention in Barranquilla and Juan Mina (Colombia): baseline characteristics of the study participants. Medicine 2018;97(1):e9285. - PMC - PubMed
ACTRN12611000518965 {published data only}
    1. ACTRN12611000518965. Achieving diabetes action and collaborative change - a cluster RCT in Aboriginal health [In Aboriginal and Torres Strait Islander peoples can a Aboriginal primary health service collaborative intervention increase screening and management of type 2 diabetes when compared with usual care]. anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336935 (first received 18 May 2011).
ACTRN12616001240437 {published data only}
    1. ACTRN12616001240437. The pharmacy diabetes screening trial: a comparison of three community pharmacy based approaches to screening for type 2 diabetes on proportions of newly diagnosed type 2 diabetes cases. anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12616001240437 (first received 6 September 2016).
ADDITION‐Leicester 2015 {published data only}
    1. Bodicoat DH, O'Donovan G, Dalton AM, Gray LJ, Yates T, Edwardson C, et al. The association between neighbourhood greenspace and type 2 diabetes in a large cross-sectional study. BMJ Open 2014;4(12):e006076. - PMC - PubMed
    1. Gray LJ, Yates T, Davies MJ, Brady E, Webb DR, Sattar N, et al. Defining obesity cut-off points for migrant South Asians. PLOS ONE 2011;6(10):e26464. - PMC - PubMed
    1. Kidy FF, Dhalwani N, Harrington DM, Gray LJ, Bodicoat DH, Webb D, et al. Associations between anthropometric measurements and cardiometabolic risk factors in white European and South Asian adults in the United Kingdom. Mayo Clinic Proceedings 2017;92(6):925-33. - PubMed
    1. Mostafa SA, Davies MJ, Morris DH, Yates T, Srinivasan BT, Webb D, et al. The association of the triglyceride-to-HDL cholesterol ratio with insulin resistance in White European and South Asian men and women. PLOS ONE 2012;7(12):e50931. - PMC - PubMed
    1. Mostafa SA, Davies MJ, Webb DR, Srinivasan BT, Gray LJ, Khunti K. Independent effect of ethnicity on glycemia in South Asians and white Europeans. Diabetes Care 2012;35(8):1746-8. - PMC - PubMed
Black 2014 {published data only}
    1. Black JA, Sharp SJ, Wareham NJ, Sandbaek A, Rutten GE, Lauritzen T, et al. Does early intensive multifactorial therapy reduce modelled cardiovascular risk in individuals with screen-detected diabetes? Results from the ADDITION-Europe cluster randomized trial. Diabetic Medicine 2014;31(6):647-56. - PMC - PubMed
Black 2015 {published data only}
    1. Black JA, Long GH, Sharp SJ, Kuznetsov L, Boothby CE, Griffin SJ, et al. Change in cardio-protective medication and health-related quality of life after diagnosis of screen-detected diabetes: results from the ADDITION-Cambridge cohort. Diabetes Research & Clinical Practice 2015;109(1):170-7. - PMC - PubMed
Charles 2011 ADDITION {published data only}
    1. Charles M, Ejskjaer N, Witte DR, Borch-Johnsen K, Lauritzen T, Sandbaek A. Prevalence of neuropathy and peripheral arterial disease and the impact of treatment in people with screen-detected type 2 diabetes: the ADDITION-Denmark study. Diabetes Care 2011;34(10):2244-9. [PMID: ] - PMC - PubMed
Charles 2013 ADDITION {published data only}
    1. Charles M, Fleischer J, Witte DR, Ejskjaer N, Borch-Johnsen K, Lauritzen T, et al. Impact of early detection and treatment of diabetes on the 6-year prevalence of cardiac autonomic neuropathy in people with screen-detected diabetes: ADDITION-Denmark, a cluster-randomised study. Diabetologia 2013;56(1):101-8. [PMID: ] - PubMed
Charles 2017 ADDITION {published data only}
    1. Charles M, Skriver MV, Griffin SJ, Simmons RK, Witte DR, Dalsgaard EM, et al. Does training and support of general practitioners in intensive treatment of people with screen-detected diabetes improve medication, morbidity and mortality in people with clinically-diagnosed diabetes? Investigation of a spill-over effect in a cluster RCT. PLOS ONE 2017;12(2):e0170697. [PMID: ] - PMC - PubMed
ChiCTR1800015274 {published data only}
    1. ChiCTR1800015274. Research on the effect of early diabetes screening and intervention on pregnancy outcome in pregnant women with high risk of diabetes. www.chictr.org.cn/showprojen.aspx?proj=26002 (first received 20 March 2018).
ChiCTR1800017260 {published data only}
    1. ChiCTR1800017260. Screening for people at risk for type 2 diabetes. apps.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR1800017260 (first received 6 July 2018).
CTRI/2016/09/007323 {published data only}
    1. CTRI/2016/09/007323. Screening and prevention of non communicable diseases (NCDs) through schools and community based approach. www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=12512&EncHid... (first received 29 September 2016).
CTRI/2017/10/010199 {unpublished data only}
    1. CTRI/2017/10/010199. Diabetes and tuberculosis - integrated management using the primary healthcare infrastructure in India [Integrated chronic disease management using the primary healthcare infrastructure in India – a feasibility]. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=15771&EncHid=&u... (first received 25 October 2017).
CTRI/2018/08/015536 {published data only}
    1. CTRI/2018/08/015536. Global health research for cardiovascular disease and diabetes. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=28022&EncHid=&u... (first received 30 August 2018).
CTRI/2018/08/015568 {published data only}
    1. CTRI/2018/08/015568. Research to practice an ideal screening model for complication of diabetes in India. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=27990&EncHid=&u... (first received 31 August 2018).
CTRI/2018/12/016532 {unpublished data only}
    1. CTRI/2018/12/016532. e health initiatives for health. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=27309&EncHid=&u... (first received 5 December 2018).
Dalsgaard 2010 ADDITION Denmark {published data only}
    1. Dalsgaard EM, Christensen JO, Skriver MV, Borch-Johnsen K, Lauritzen T, Sandbaek A. Comparison of different stepwise screening strategies for type 2 diabetes: finding from Danish general practice, Addition-DK. Primary Care Diabetes 2010;4(4):223-9. [PMID: ] - PubMed
Dalsgaard 2014 ADDITION {published data only}
    1. Dalsgaard EM, Vestergaard M, Skriver MV, Borch-Johnsen K, Lauritzen T, Sandbaek A. Socioeconomic position and cardiovascular risk factors among people with screen-detected type 2 DM: six-year follow-up of the ADDITION-Denmark trial. Primary Care Diabetes 2014;8(4):322-9. [PMID: ] - PubMed
den Ouden 2015 ADDITION {published data only}
    1. den Ouden H, Berends J, Stellato RK, Beulens JW, Rutten GE. Effect of six years intensified multifactorial treatment on levels of hs-CRP and adiponectin in patients with screen detected type 2 diabetes: the ADDITION-Netherlands randomized trial. Diabetes/Metabolism Research and Reviews 2015;31(7):758-66. [PMID: ] - PubMed
DRKS00009837 {unpublished data only}
    1. DRKS00009837. Diabetes mellitus screening for ambulant an in hospital patients - feasibility study [Diabetes mellitus screening bei stationären und ambulanten Patienten - Machbarkeitsstudie]. www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DR... (first received 25 February 2016).
Dunkley 2017 {published data only}
    1. Dunkley AJ, Tyrer F, Spong R, Gray LJ, Gillett M, Doherty Y, et al. Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project. In: NIHR Journals Library. National Library of Medicine, National Institutes of Health, 2017. - PubMed
Eborall 2007 ADDITION {published data only}
    1. Eborall HC, Griffin SJ, Prevost AT, Kinmonth AL, French DP, Sutton S. Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial. BMJ 2007;335(7618):486. - PMC - PubMed
Griffin 2011 ADDITION {published data only}
    1. Griffin SJ, Borch-Johnsen K, Davies MJ, Khunti K, Rutten GE, Sandbaek A, et al. Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. Lancet (London, England) 2011;378(9786):156-67. [PMID: ] - PMC - PubMed
Harris 2003 {published data only}
    1. Harris RP, Lux LJ, Bunton AJ, Sutton SF, Lohr KN, Donahue KP, et al. Screening adults for type 2 diabetes: a review of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2003;138:215-29. - PubMed
Hellgren 2015 {published data only}
    1. Hellgren M, Daka B, Larsson C. HbA1c is not enough in screening for impaired glucose metabolism. Glucose tolerance tests are also needed, as shown in Swedish prospective epidemiological study. Lakartidningen 2015;112:29. - PubMed
Herman 2015 {published data only}
    1. Herman WH, Ye W, Griffin SJ, Simmons RK, Davies MJ, Khunti K, et al. Early detection and treatment of type 2 diabetes reduce cardiovascular morbidity and mortality: a simulation of the results of the Anglo-Danish-Dutch study of intensive treatment in people with screen-detected diabetes in primary care (ADDITION-Europe). Diabetes Care 2015;38:1449-55. - PMC - PubMed
ISRCTN21333761 {published data only}
    1. ISRCTN21333761. Better prevention and screening: personalized clinical visits for adults. www.isrctn.com/ISRCTN21333761 (first received 31 August 2016).
ISRCTN57962668 {published data only}
    1. ISRCTN57962668. Multi-centre risk-based screening for diabetes and its complications. www.isrctn.com/ISRCTN57962668 (first received 18 August 2018).
Johansen 2012 ADDITION {published data only}
    1. Johansen NB, Charles M, Vistisen D, Rasmussen SS, Wiinberg N, Borch-Johnsen K, et al. Effect of intensive multifactorial treatment compared with routine care on aortic stiffness and central blood pressure among individuals with screen-detected type 2 diabetes: the ADDITION-Denmark study. Diabetes Care 2012;35(11):2207-14. [PMID: ] - PMC - PubMed
Juul 2009 ADDITION {published data only}
    1. Juul L, Sandbaek A, Foldspang A, Frydenberg M, Borch-Johnsen K, Lauritzen T. Adherence to guidelines in people with screen-detected type 2 diabetes, ADDITION, Denmark. Scandinavian Journal of Primary Health Care 2009;27(4):223-31. [PMID: ] - PMC - PubMed
Kenealy 2007 {published data only}
    1. Kenealy T, Elley CR, Arroll B. Screening for diabetes and prediabetes. Lancet 2007;370:1888-9. - PubMed
Kolaczynski 2000 {published data only}
    1. Kolaczynski JW. Comments on type 2 diabetes screening and treatment. American Family Physician 2000;61:49-50. - PubMed
Kullgren 2017 {published data only}
    1. Kullgren JT, Youles B, Shetty S, Richardson C, Fagerlin A, Heisler M. Forging new paths in diabetes prevention (FINDIT): study protocol for a randomized controlled trial. Trials 2017;18:167. [DOI: 10.1186/s13063-017-1887-6] - DOI - PMC - PubMed
Kumar 2015 {published data only}
    1. Kumar S, Shewade HD, Vasudevan K, Durairaju K, Santhi VS, Sunderamurthy B, et al. Effect of mobile reminders on screening yield during opportunistic screening for type 2 diabetes mellitus in a primary health care setting: a randomized trial. Preventive Medicine Reports 2015;2:640-4. - PMC - PubMed
Kuznetsov 2015 ADDITION {published data only}
    1. Kuznetsov L, Simmons RK, Sandbaek A, Maindal HT. The impact of intensive multifactorial treatment on perceptions of chronic care among individuals with screen-detected diabetes: results from the ADDITION-Denmark trial. International Journal of Clinical Practice 2015;69(4):466-73. [PMID: ] - PubMed
Lau 2016 {published data only}
    1. Lau CJ, Pisinger C, Husemoen LLN, Jacobsen RK, Linneberg A, Jorgensen T, et al. Effect of general health screening and lifestyle counselling on incidence of diabetes in general population: inter99 randomised trial. Preventive Medicine 2016;91:172-9. - PubMed
Lauritzen 2000 ADDITION {published data only}
    1. Lauritzen T, Griffin S, Borch-Johnsen K, Wareham NJ, Wolffenbuttel BH, Rutten G. The ADDITION study: proposed trial of the cost-effectiveness of an intensive multifactorial intervention on morbidity and mortality among people with Type 2 diabetes detected by screening. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity 2000;24 Suppl 3:S6-11. [PMID: ] - PubMed
Lauritzen 2011 ADDITION {published data only}
    1. Lauritzen T, Sandbaek A, Skriver MV, Borch-Johnsen K. HbA1c and cardiovascular risk score identify people who may benefit from preventive interventions: a 7 year follow-up of a high-risk screening programme for diabetes in primary care (ADDITION), Denmark. Diabetologia 2011;54(6):1318-26. [PMID: ] - PubMed
Law 2018 {published data only}
    1. Law V, Featherstone T, Eurich DT, Simpson SH. Knowledge of a diabetes risk score does not alter diabetes screening practice in a seniors population: a randomized controlled trial. Journal of the American Medical Directors Association 2018;19(11):1021-3. - PubMed
Maindal 2013 ADDITION {published data only}
    1. Maindal HT, Toft U, Lauritzen T, Sandbaek A. Three-year effects on dietary quality of health education: a randomized controlled trial of people with screen-detected dysglycaemia (The ADDITION study, Denmark). European Journal of Public Health 2013;23(3):393-8. [PMID: ] - PubMed
Monti 2012 {published data only}
    1. Monti LD, Lucotti PC, Setola E, Rossodivita A, Pala MG, Galluccio E, et al. Effects of chronic elevation of atrial natriuretic peptide and free fatty acid levels in the induction of type 2 diabetes mellitus and insulin resistance in patients with mitral valve disease. Nutrition, Metabolism and Cardiovascular Diseases: NMCD 2012;22(1):58-65. [PMID: ] - PubMed
NCT00007696 {published data only}
    1. NCT00007696. Finding diabetes mellitus among veterans [CSP #705D - Screening for diabetes mellitus in veterans]. clinicaltrials.gov/ct2/show/NCT00007696 (first received 4 January 2001).
NCT00042042 {published data only}
    1. NCT00042042. Screening adolescents for type 2 diabetes mellitus in a community clinic. clinicaltrials.gov/ct2/show/NCT00042042 (first received 23 July 2002).
NCT00253240 {published data only}
    1. NCT00253240. Diabetes screening, risk management and disease management in a high-risk mental health population. clinicaltrials.gov/show/NCT00253240 (first received 15 November 2005).
NCT00377117 {published data only}
    1. NCT00377117. Diabetes screening, risk management and disease management in a high-risk mental health population part II. clinicaltrials.gov/ct2/show/NCT00377117 (first received 15 September 2006).
NCT01591525 {published data only}
    1. NCT01591525. Diabetes mellitus community based screening in minority populations. clinicaltrials.gov/ct2/show/NCT01591525 (first received 4 May 2012).
NCT02223793 {published data only}
    1. NCT02223793. Effects of cardiovascular risk screening in pharmacies: a randomized study. clinicaltrials.gov/ct2/show/NCT02223793 (first received 22 August 2014).
NCT02418637 {published data only}
    1. NCT02418637. Pilot study testing feasibility of health screening at farm site. clinicaltrials.gov/show/NCT02418637 (first received 16 April 2015).
NCT02513277 {published data only}
    1. NCT02513277. Diabetes screening & prevention for people with learning (intellectual) disabilities: STOP diabetes study. [Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with learning disabilities]. clinicaltrials.gov/ct2/show/NCT02513277 (first received 31 July 2015).
NCT02750527 {published data only}
    1. NCT02750527. Pediatric population screening for type 1 diabetes and familial hypercholesterolemia in Lower Saxony, Germany (Fr1dolin). clinicaltrials.gov/ct2/show/NCT02750527 (first received 25 April 2016).
NCT03254979 {published data only}
    1. NCT03254979. Optimizing the Primary Prevention of Type-2 Diabetes in Primary Health Care (PREDIAPS) [How to Engage Primary Health Care Providers in an Inter-professional Collaborative Modeling Processfor the Optimization of Type-2 Diabetes Primary Prevention: a Randomized Hybrid Implementation Trial]. https://clinicaltrials.gov/ct2/show/NCT03254979 21 August 2017.
NCT03395509 {published data only}
    1. NCT03395509. The intersectional Viborg screening program: cost-(effectiveness) of screening for diabetes and cardiovascular diseases (VISP). clinicaltrials.gov/ct2/show/NCT03395509 (first received 10 January 2018).
Park 2008 {published data only}
    1. Park P, Simmons RK, Prevost AT, Griffin SJ. Screening for type 2 diabetes is feasible, acceptable, but associated with increased short-term anxiety: a randomised controlled trial in British general practice. BMC Public Health 2008;8:350. - PMC - PubMed
Raikou 2003 {published data only}
    1. Raikou M, McGuire A. The economics of screening and treatment in type 2 diabetes mellitus. Pharmacoeconomics 2003;21:543-64. - PubMed
Rasmussen 2016 {published data only}
    1. Rasmussen SS, Johansen NB, Witte DR, Borch-Johnsen K, Sandbaek A, Lauritzen T, et al. Incidence of register-based diabetes 10 years after a stepwise diabetes screening programme: the ADDITION-Denmark study. Diabetologia 2016;59(5):989-97. - PubMed
Reid 1974 {published data only}
    1. Reid DD, Brett GZ, Hamilton PJ, Jarrett RJ, Keen H, Rose G. Cardiorespiratory disease and diabetes among middle-aged male Civil Servants. A study of screening and intervention. Lancet 1974;1:469-73. - PubMed
Rubak 2009 ADDITION {published data only}
    1. Rubak S, Sandbaek A, Lauritzen T, Borch-Johnsen K, Christensen B. General practitioners trained in motivational interviewing can positively affect the attitude to behaviour change in people with type 2 diabetes. One year follow-up of an RCT, ADDITION Denmark. Scandinavian Journal of Primary Health Care 2009;27(3):172-9. [PMID: ] - PMC - PubMed
Scherstén 1966 {published data only}
    1. Scherstén B. Health control. VI. Evaluation of screening methods for diabetes. Lakartidningen 1966;63:2659-64. [PMID: ] - PubMed
Simmons 2011 {published data only}
    1. Rahman M, Simmons RK, Hennings SH, Wareham NJ, Griffin SJ. Effect of screening for Type 2 diabetes on population level self-rated health outcomes and measures of cardiovascular risk: 13-year follow-up of the Ely cohort. Diabetic Medicine 2012;29:886-92. - PMC - PubMed
    1. Rahman M, Simmons RK, Hennings SH, Wareham NJ, Griffin SJ. How much does screening bring forward the diagnosis of type 2 diabetes and reduce complications? Twelve year follow-up of the Ely cohort. Diabetologia 2012;55:1651-9. - PubMed
    1. Simmons RK, Rahman M, Jakes RW, Yuyun MF, Niggebrugge AR, Hennings SH, et al. Effect of population screening for type 2 diabetes on mortality: long-term follow-up of the Ely cohort. Diabetologia 2011;54:312-9. - PubMed
Simmons 2012b ADDITION {published data only}
    1. Simmons RK, Sharp SJ, Sandbaek A, Borch-Johnsen K, Davies MJ, Khunti K, et al. Does early intensive multifactorial treatment reduce total cardiovascular burden in individuals with screen-detected diabetes? Findings from the ADDITION-Europe cluster-randomized trial. Diabetic Medicine 2012;29(11):e409-16. - PMC - PubMed
Simmons 2014 ADDITION {published data only}
    1. Simmons RK, Carlsen AH, Griffin SJ, Charles M, Christiansen JS, Borch-Johnsen K, et al. Variation in prescribing of lipid-lowering medication in primary care is associated with incidence of cardiovascular disease and all-cause mortality in people with screen-detected diabetes: findings from the ADDITION-Denmark trial. Diabetic Medicine: a Journal of the British Diabetic Association 2014;31(12):1577-85. [PMID: ] - PMC - PubMed
Simmons 2017a_ADDITION Denmark {published data only}
    1. Simmons RK, Griffin SJ, Witte DR, Borch-Johnsen K, Lauritzen T, Sandbaek A. Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults. Diabetologia 2017;60(11):2183-91. - PMC - PubMed
Simmons 2017 ADDITION {published data only}
    1. Simmons RK, Bruun NH, Witte DR, Borch-Johnsen K, Jørgensen ME, Sandbaek A, et al. Does training of general practitioners for intensive treatment of people with screen-detected diabetes have a spillover effect on mortality and cardiovascular morbidity in 'at risk' individuals with normoglycaemia? Results from the ADDITION-Denmark cluster-randomised controlled trial. Diabetologia 2017;60(6):1016-21. - PMC - PubMed
Simmons 2017b_ADDITION Denmark {published data only}
    1. Simmons RK, Griffin SJ, Lauritzen T, Sandbaek A. Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009. Diabetologia 2017;60(11):2192-9. - PMC - PubMed
Skaaby 2018 {published data only}
    1. Skaaby T, Jorgensen T, Linneberg A. A randomized general population study of the effects of repeated health checks on incident diabetes. Endocrine 2018;60(1):122-8. - PubMed
Sortso 2018 {published data only}
    1. Sortso C, Komkova A, Sandbaek A, Griffin SJ, Emneus M, Lauritzen T, et al. Effect of screening for type 2 diabetes on healthcare costs: a register-based study among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009. Diabetologia 2018;61(6):1306-14. - PMC - PubMed
Spijkerman 2003 {published data only}
    1. Spijkerman AM, Dekker JM, Nijpels G, Adriaanse MC, Kostense PJ, Ruwaard D, et al. Microvascular complications at time of diagnosis of type 2 diabetes are similar among diabetic patients detected by targeted screening and patients newly diagnosed in general practice: the Hoorn screening study. Diabetes Care 2003;26:2604-8. - PubMed
Su 2017 {published data only}
    1. Su XF, Sun L, Liu BL, Tao XJ, Li HQ, Li FF, et al. An intensive diabetes screening and treatment program improves diagnosis, treatment and outcomes of diabetes in patients admitted with cardiac diseases. Experimental and Clinical Endocrinology & Diabetes 2017;125(3):151-5. - PubMed
van den Donk 2013 ADDITION {published data only}
    1. Van den Donk M, Griffin SJ, Stellato RK, Simmons RK, Sandbaek A, Lauritzen T, et al. Effect of early intensive multifactorial therapy compared with routine care on self-reported health status, general well-being, diabetes-specific quality of life and treatment satisfaction in screen-detected type 2 diabetes mellitus patients (ADDITION-Europe): a cluster-randomised trial. Diabetologia 2013;56(11):2367-77. [PMID: ] - PMC - PubMed
Villarivera 2012 {published data only}
    1. Villarivera C, Wolcott J, Jain A, Zhang Y, Goodman C. Analysis & commentary: the US Preventive Services Task Force should consider a broader evidence base in updating its diabetes screening guidelines. Health Affairs 2012;31:35-42. - PubMed
Von Karla 2007 {published data only}
    1. Von Karla V, Hewett ML. Type 2 diabetes in children and adolescents: screening, diagnosis, and management. JAAPA 2007;20:51-4. - PubMed

References to studies awaiting assessment

Klijs 2012 {published data only}
    1. ISRCTN75983009. Population-based randomized controlled trial of screening for type 2 diabetes mellitus in high-risk subjects. www.isrctn.com/ISRCTN75983009 (first received 15 May 2006).
    1. Klijs B, Otto SJ, Heine RJ, Graaf Y, Lous JJ, Koning HJ. Screening for type 2 diabetes in a high-risk population: study design and feasibility of a population-based randomized controlled trial. BMC Public Health 2012;12:671. [PMID: ] - PMC - PubMed
    1. Willems JI, Otto SJ, Klijs B, Koning HJ. Screening for type 2 diabetes in a high-risk population: effects of a negative screening test after 4 years follow-up. Annals of Behavioral Medicine 2014;47(1):102-10. [PMID: ] - PubMed

Additional references

ADA 2002
    1. American Diabetes Association. Screening for type 2 diabetes. Diabetes Care 2002;25(Suppl 1):S21-4. - PubMed
ADA 2003
    1. American Diabetes Association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003;26(Suppl 1):S5-20. - PubMed
ADA 2004
    1. American Diabetes Association. Screening for type 2 diabetes. Diabetes Care 2004;27(Suppl 1):S11-4. - PubMed
ADA 2008
    1. American Diabetes Association. Standards of medical care - 2008. Diabetes Care 2008;31:S12-54. - PubMed
ADA 2010
    1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33(Suppl 1):S62-9. - PMC - PubMed
ADA 2014
    1. American Diabetes Association. Diabetes and classification of diabetes mellitus. Diabetes Care 2014;37(1):S81-90. - PubMed
Altman 2003
    1. Altman DG, Bland JM. Interaction revisited: the difference between two estimates. BMJ 2003;326(7382):219. [PMID: ] - PMC - PubMed
Andermann 2008
    1. Andermann A, Blancquaert I, Beauchamp S, Déry V. Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bulletin of the World Health Organization 2008;86(4):317-9. - PMC - PubMed
Bell 2013
    1. Bell ML, McKenzie JE. Designing psycho-oncology randomised trials and cluster randomised trials: variance components and intra-cluster correlation of commonly used psychosocial measures. Psycho-Oncology 2013;22:1738-47. - PubMed
Borch‐Johnsen 2003
    1. Borch-Johnsen K, Lauritzen T, Glumer C, Sandbaek A. Screening for Type 2 diabetes - should it be now? Diabetic Medicine 2003;20(3):175-81. - PubMed
Borenstein 2017a
    1. Borenstein M, Higgins JP, Hedges LV, Rothstein HR. Basics of meta-analysis: I² is not an absolute measure of heterogeneity. Research Synthesis Methods 2017;8(1):5-18. - PubMed
Borenstein 2017b
    1. Borenstein M. Prediction intervals. www.meta-analysis.com/prediction (accessed 3 July 2017).
Boutron 2014
    1. Boutron I, Altman DG, Hopewell S, Vera-Badillo F, Tannock I, Ravaud P. Impact of spin in the abstracts of articles reporting results of randomized controlled trials in the field of cancer: the SPIIN randomized controlled trial. Journal of Clinical Oncology 2014;32(36):4120-6. - PubMed
Canadian Task Force 2012
    1. Canadian Task Force on Preventive Health Care. Recommendations on screening for type 2 diabetes in adults. CMAJ 2012;184(15):1687-96. - PMC - PubMed
Carroll 2015
    1. Carroll AE. How useful are screening tests? JAMA 2015;313(13):1304. - PubMed
Colagiuri 2002
    1. Colagiuri S, Cull CA, Holman RR. Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes?: U.K. Prospective Diabetes Study 61. Diabetes Care 2002;25(8):1410-7. - PubMed
Corbett 2014
    1. Corbett MS, Higgins JP, Woolacott NF. Assessing baseline imbalance in randomised trials: implications for the Cochrane risk of bias tool. Research Synthesis Methods 2014;5:79-85. - PubMed
Deeks 2019
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Diabetes UK 2020
    1. Diabetes UK. Early identification of people with type 2 diabetes; updated: April 2020. www.diabetes.org.uk/professionals/position-statements-reports/type-2-dia... (accessed prior to 27 May 2020).
Durão 2015
    1. Durão S, Ajumobi O, Kredo T, Naude C, Levitt NS, Steyn K, et al. Evidence insufficient to confirm the value of population screening for diabetes and hypertension in low- and-middle-income settings. South African Medical Journal 2015;105(2):98-102. - PubMed
Eborall 2007
    1. Eborall HC, Griffin SJ, Prevost AT, Kinmonth AL, French DP, Sutton S. Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial. BMJ 2007;335(7618):486-93. - PMC - PubMed
Echouffo‐Tcheugui 2015
    1. Echouffo-Tcheugui JB, Simmons RK, Prevost AT, Williams KM, Kinmonth AL, Wareham NJ, et al. Long-term effect of population screening for diabetes on cardiovascular morbidity, self-rated health, and health behavior. Annals of Family Medicine 2015;13(2):149-57. - PMC - PubMed
Expert Committee 1997
    1. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997;20(7):1183-97. - PubMed
Griffin 2012
    1. Griffin SJ, Borch-Johnsen K, Davies MJ, Khunti K, Rutten GE, Sandbaek A, et al. Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. Lancet 2011;378(9786):156-67. - PMC - PubMed
Grimes 2002
    1. Grimes D, Schulz K. Use and abuses of screening tests. Lancet 2002;359(9309):881-4. - PubMed
Harris 1992
    1. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care 1992;15(7):815-9. - PubMed
Higgins 2002
    1. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statistics in Medicine 2002;21:1539-58. - PubMed
Higgins 2003
    1. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analysis. BMJ 2003;327:557-60. - PMC - PubMed
Higgins 2019a
    1. Higgins JP, Li T, Deeks JJ (editors). Chapter 6: Choosing effect measures and computing estimates of effect. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Higgins 2019b
    1. Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA. Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Hozo 2005
    1. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Medical Research Methodology 2005;5:13. [DOI: 10.1186/1471-2288-5-13] - DOI - PMC - PubMed
Hróbjartsson 2013
    1. Hróbjartsson A, Thomsen AS, Emanuelsson F, Tendal B, Hilden J, Boutron I, et al. Observer bias in randomized clinical trials with measurement scale outcomes: a systematic review of trials with both blinded and nonblinded assessors. Canadian Medical Association Journal 2013;185(4):E201-11. - PMC - PubMed
IDF 2012
    1. Clinical Guidelines Task Force. Global Guideline for Type 2 Diabetes. Brussels: International Diabetes Federation, 2012.
IDF 2019
    1. International Diabetes Federation. IDF Diabetes Atlas, ninth edition 2019. Available at: https://www.diabetesatlas.org 2019.
International Expert Committee 2009
    1. International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 2009;32:1327-34. - PMC - PubMed
Inzucchi 2012
    1. Inzucchi SE. Clinical practice. Diagnosis of diabetes. New England Journal of Medicine 2012;367(6):542-50. - PubMed
Jones 2015
    1. Jones CW, Keil LG, Holland WC, Caughey MC, Platts-Mills TF. Comparison of registered and published outcomes in randomized controlled trials: a systematic review. BMC Medicine 2015;13:282. [DOI: 10.1186/s12916-015-0520-3] - DOI - PMC - PubMed
Kirkham 2010
    1. Kirkham JJ, Dwan KM, Altman DG, Gamble C, Dodd S, Smyth R, et al. The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews. BMJ 2010;340:c365. [DOI: 10.1136/bmj.c365] - DOI - PubMed
Lauritzen 2000
    1. Lauritzen T, Griffin S, Borch-Johnsen K, Wareham NJ, Wolffenbuttel BH, Rutten G. The ADDITION study: proposed trial of the cost-effectiveness of an intensive multifactorial intervention on morbidity and mortality among people with type 2 diabetes detected by screening. International Journal of Obesity and Related Metabolic Disorders 2000;24 Suppl 3:S6-11. [PMID: ] - PubMed
Liberati 2009
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLOS Medicine/Public Library of Science 2009;6:e1000100. [DOI: 10.1371/journal.pmed.1000100] - DOI - PMC - PubMed
Mathieu 2009
    1. Mathieu S, Boutron I, Moher D, Altman DG, Ravaud P. Comparison of registered and published primary outcomes in randomized controlled trials. JAMA 2009;302:977-84. - PubMed
Meader 2014
    1. Meader N, King K, Llewellyn A, Norman G, Brown J, Rodgers M, et al. A checklist designed to aid consistency and reproducibility of GRADE assessments: development and pilot validation. Systematic Reviews 2014;3:82. - PMC - PubMed
Peer 2014
    1. Peer N, Kengne AP, Motala A, Mbanya JC. Diabetes in the Africa region: an update. Diabetes Research and Clinical Practice 2014;103(2):197-205. - PubMed
RevMan 2014 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Riley 2011
    1. Riley RD, Higgins JP, Deeks JJ. Interpretation of random effects meta-analyses. BMJ 2011;342:d549. - PubMed
Rutten 2006
    1. Rutten GE, Grauw WJ, Nijpels G, Goudswaard AN, Uitewaal PJ, Does FE, et al. Dutch College of General Practitioners' guidelines on type 2 diabetes mellitus (second revision). Huisarts en Wetenschap 2006;49:137-52.
Sandbaek 2008
    1. Sandbaek A, Griffin SJ, Rutten G, Davies M, Stolk R, Khunti K, et al. Stepwise screening for diabetes identifies people with high but modifiable coronary heart disease risk. The ADDITION study. Diabetologia 2008;51(7):1127-34. - PMC - PubMed
Saquib 2015
    1. Saquib N, Saquib J, Ioannidis JP. Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials. International Journal of Epidemiology 2015;44(1):264-77. - PubMed
Schünemann 2019
    1. Schünemann HJ, Higgins JP, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14: Completing ‘Summary of findings’ tables and grading the confidence in or quality of the evidence. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.
Selph 2015
    1. Selph S, Dana T, Blazina I, Bougatsos C, Patel H, Chou R. Screening for type 2 diabetes mellitus: a systematic review for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2015;162:765-76. - PubMed
Sherifali 2013
    1. Sherifali D, Fitzpatrick-Lewis D, Peirson L, Ciliska D, Coyle D. Screening for type 2 diabetes in adults: an updated systematic review. Open Diabetes Journal 2013;6:1-13.
Standing committee on screening 2018
    1. Standing Committee on Screening. Population based screening framework; updated August 2018. www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/pop....
Sterne 2017
    1. Sterne JA, Egger M, Moher D, Boutron I (editors). Chapter 10: Addressing reporting biases. In: Higgins JP, Churchill R, Chandler J, Cumpston MS (editors). Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017). Cochrane, 2017. Available from www.training.cochrane.org/handbook.
Waugh 2007
    1. Waugh N, Scotland G, McNamee P, Gillett M, Brennan A, Goyder E, et al. Screening for type 2 diabetes: literature review and economic modelling. Health Technology Assessment 2007;11(17):1-125. - PubMed
Waugh 2013
    1. Waugh NR, Shyangdan D, Taylor-Phillips S, Suri G, Hall B. Screening for type 2 diabetes: a short report for the National Screening Committee. Health Technology Assessment 2013;17(35):1-90. [DOI: 10.3310/hta17350] - DOI - PMC - PubMed
WHO 1985
    1. WHO Study Group on Diabetes Mellitus & World Health Organization. Diabetes mellitus: report of a WHO study group [‎meeting held in Geneva from 11 to 16 February 1985]‎. World Health Organization technical report series ; no. 727. apps.who.int/iris/handle/10665/39592.
WHO 1999
    1. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. apps.who.int/iris/handle/10665/66040.
WHO 2003
    1. World Health Organization. Screening for type 2 diabetes. Report of a WHO and IDF meeting. who.int/diabetes/publications/screening2003/en/.
Wood 2008
    1. Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ 2008;336(7644):601-5. - PMC - PubMed

References to other published versions of this review

Klein Woolthuis 2005
    1. Klein Woolthuis EP, De Grauw WJC, Van de Laar FA, Akkermans RP. Screening for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2005, Issue 2. [DOI: 10.1002/14651858.CD005266] - DOI - PMC - PubMed

Publication types

Associated data