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Don’t screen for diabetes

November 3, 2012

Ignore Movember

The UK National Screening Committee has long advised against routine screening for diabetes, and this sensible stance received an important boost from the ADDITION trial in last month’s Lancet (click here).

ADDITION was a cluster trial involving 20,000 people in 33 general practices in Eastern England. In the intervention practices high risk individuals (60% men) age 40-70, not already diagnosed with diabetes, were invited for screening. In control practices they were not. In all practices people diagnosed with diabetes were treated according to current guidelines.

The trial protocol was published here. They hit their planned sample size, reported their predetermined endpoints and prespecified their analysis plans.

Here are the main results expressed as relative risk and 95% confidence intervals.  Numbers greater than one mean more deaths in the screening practices:

Diabetes related mortality;  1·26, 0·75–2·10
Cardiovascular mortality; 1·02, 0·75–1·38
Cancer mortality; 1·08, 0·90–1·30
Other causes of death; 1·10, 0·87–1·39

And here’s the all cause mortality graph

I wonder why those clowns at Movember still recommend  diabetes screening for men over 40.

Jim Thornton

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