[Screening studies in diagnosis of diabetes. Do they still have practical value?]

Abstract

The WHO has defined standardized diagnostic criteria for manifest diabetes mellitus and disorders of glucose tolerance. Owing to a low level of sensitivity and only moderate specificity, coupled with an unfavorable cost-benefit rating, glucosuria screening is not suitable for large-scale use at population level and, as recommended by the WHO, should be replaced by plasma glucose screening. The method of choice for the latter is the determination of the fasting plasma glucose level. Its use should be restricted to target groups with a high risk of contracting diabetes. In the doctor's office, a health check is of particular importance for the diagnosis of type 2 diabetes, which is usually asymptomatic. Screening for diabetes with the aid of a 50 g oral dose of glucose to detect gestational diabetes is a must during pregnancy.