Screening for prediabetes and diabetes

Abstract

Screening populations at risk for a disease, applying interventions to halt or reverse the progression to overt clinical syndrome, and preventing future morbidity and/or mortality in a cost-effective manner have been a subject for extensive research for several decades for many common health problems. In 1968, the World Health Organization commissioned a report on screening by Wilson and Jungner entitled Principles and practice of screening for disease which has since become a classic and widely accepted doctrine in the science of public health [ 1 ]. Wilson and Jungner attempted to de fi ne screening criteria to guide the selection of conditions that would be suitable for screening, based on the following, among other, principles: (1) The condition sought should be an important health problem. (2) There should be an accepted treatment for patients with recognized disease. (3) There should be a recognizable latent or early symptomatic stage. (4) There should be a suitable test or examination. (5) The test should be acceptable to the population. (6) The natural history of the condition, including development from latent to declared disease, should be adequately understood. (7) There should be an agreed policy on whom to treat as patients. (8) The cost of case- fi nding (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care as a whole.