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August 24, 2021

Updated USPSTF Screening Recommendations for Diabetes: Identification of Abnormal Glucose Metabolism in Younger Adults

Author Affiliations
  • 1Division of Research, Kaiser Permanente Northern California, Oakland
  • 2Associate Editor, JAMA Internal Medicine
  • 3The Permanente Medical Group, San Francisco Medical Center, South San Francisco, California
JAMA Intern Med. 2021;181(10):1284-1286. doi:10.1001/jamainternmed.2021.4886

The diabetes epidemic in the US continues unabated hand in hand with the concurrent epidemics of obesity and physical inactivity. At present, there are about 34 million US adults living with type 2 diabetes (10.2% of the US adult population). Another 88 million US adults have abnormal glucose levels that fall short of a diabetes diagnosis (an additional 34.5% of the adult US population).1,2 These numbers reflect the fact that nearly 75% of US adults have a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) in the overweight or obese range,3 and 45% engage in no moderate- or vigorous-intensity physical activity in a typical week.4 Despite convincing evidence supporting guidelines for lifestyle change and medical therapy, progress in the control of diabetes-related risk factors (ie, hypertension, dyslipidemia, hyperglycemia) has plateaued5,6 or, in some cases, may have worsened.7 As a result, millions of individuals remain at risk for the microvascular and macrovascular complications of diabetes, disability, and early mortality. The gaps in receipt of recommended care are greater for younger adults (aged 18-44 years) and members of at-risk racial and ethnic groups (American Indian/Alaska Native, Asian American, Black, Hispanic/Latinx, and Native Hawaiian/Pacific Islander adults) than for other adults.8

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