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Diabetes is known to be a silent disease, evolving quietly for a long time before being diagnosed. Screening for diabetes in people aged 40 to 70 would therefore detect the disease two years earlier, according to a study.
Often referred to as the “epidemic of the century”, diabetes affects nearly 500 million people worldwide. In France, more than 3.5 million people are affected by this chronic disease, type 2 diabetes for the vast majority of patients (90%).
In France, approximately 600,000 people are unaware that they are diabetic and according to the latest Entred 3 survey, published by Public Health France, a type 2 diagnosis is made on average 10 years after the onset of the disease.
How many diabetics are unaware of their diagnosis?
The UK is experiencing the same problem, with Diabetes UK estimating that there are 850,000 people living with undiagnosed diabetes in the country. Faced with this observation, the authors of this work had the idea of evaluating the benefits of screening for diabetes in people aged between 40 and 70 years. To do this, they used participants’ data from the UK Biobank, in particular glycated hemoglobin (HbA1c), which was measured when they registered.
HbA1c reflects a person’s blood sugar control over the past 2-3 months. More practical than the oral glucose tolerance test, it is more widely used. HbA1c is expressed as an absolute value (mmol/mol) or as a percentage, with a threshold of 48 mmol/mol or more (6.5% or more) usually used to diagnose diabetes.
One in ten people over 40 have diabetes without knowing it
Participants’ HbA1c results were not shared with participants or their physicians. Subsequently, the researchers then analyzed the 179,923 participants through their health data.
They identified 13,077 people affected by the disease and who knew about it, or 7.3% of the cohort. Among the remaining participants, ie the 166,846 other participants, theoretically not affected by the disease, 1,703 were nevertheless diabetics, without knowing it, or 1% of the group.
By extrapolation, as there are 25 million adults between the ages of 40 and 70 living in the UK, the researchers estimate that 250,000 Britons could be diagnosed with diabetes through screening and therefore start treatment early, on average two years ago.
A low estimate because, they point out, the data from the UK Biobank is not entirely representative of the British population, the fact that certain populations very affected by diabetes, such as blacks and South Asians, are underestimated there. represented and that access to care is more difficult for these populations. Indeed, other more representative studies do not estimate the percentage at 1 but rather between 2.8% and 4.5%.
The opinion of Dr Alain Scheimann, endocrinologist in Paris
“Type 2 diabetes is a silent disease occurring preferentially after the age of 40. It is therefore legitimate to look for hyperglycaemia in all adults over 40, especially in those at risk of diabetes such as a family history, gestational diabetes , proven overweight or cardiovascular disease. Early detection of prediabetes makes it possible to put in place lifestyle and dietary measures, possibly associated with new drugs aimed at losing weight and therefore reducing the risk of onset of irreversible diabetes”.