Value of screening for and treating pre-diabetes is reduced by low test accuracy and indirect evidence of impact on patient important outcomes.

Abstract

Commentary on: Barry E, Roberts S, Oke J, et al . Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions. BMJ 2017;356:i6538. Type 2 diabetes is a major cause of morbidity and mortality. Hoping to reduce the burden of diabetes on people and societies, guidelines have recommended screening for hyperglycaemia in healthy population.1 These recommendations assume that early detection and intervention can prevent the morbimortality associated with type 2 diabetes and its complications.1 The systematic review by Barry et al sought to evaluate the accuracy of screening and the efficacy of early intervention (lifestyle or metformin) to prevent type 2 diabetes1. They conducted a rigorous systematic review of the published literature until June 2016. They then conducted two meta-analyses. The first one, a bivariate random-effects model meta-analysis, summarised …