Why You Might Be Tested For Type 2 Diabetes at Your Next Physical, Even if You Don't Have Family History

If you're between age 35 and 70, listen up.

a photo of a doctor reviewing lab results to a patient
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Each time you visit your doctor for a physical, you'll likely be asked to review your family history for a wide variety of conditions, ranging from depression and dementia to heart disease and type 2 diabetes. This makes sense, since genetics play a strong role in our risk for all of the above.

Our lifestyle habits definitely contribute to our overall risk profile as well, which is why researchers are so keen on learning more about the small changes we can integrate over time to potentially decrease our risk for some of the leading causes of death in the U.S.

A mounting pool of scientific evidence suggests that if you integrate add these 6 healthy habits to your daily routine, you might be able to significantly reduce your risk for type 2 diabetes, and push its precursor, prediabetes (the term for if your blood sugar is elevated, but not high enough for an official type 2 diagnosis) into remission.

While those are healthy habits for all of us to integrate, it can be extra motivating if you're aware that you're teetering on the edge between prediabetes and type 2 diabetes—so it's crystal clear that it's time to prioritize those action items. According to the latest estimates from the U.S. Centers for Disease Control and Prevention (CDC), a sizable portion of Americans are toeing that line. But since many of the signs and symptoms can be silent, many might have no idea. About 96 million Americans—more than 1 in 3 of us—have prediabetes, the CDC reports, but only 20% of those individuals know that they do.

For this reason, in 2021, the U.S. Preventive Services Task Force (USPSTF) recommended that all adults between age 35 and 70 who qualify as having a body mass index (BMI) in the "overweight" or "obese" ranges should be screened for prediabetes and type 2 diabetes via a blood glucose test. (This is 5 years earlier than the previously-endorsed initial screening age.) The researchers involved in a new study published March 24, 2023 in the American Journal of Preventive Medicine say that regardless of weight, in order to promote health equity, all adults between 35 and 70 would be best served being screened regularly for prediabetes.

Read on to learn more about the latest findings that inspired them to make this recommendation, plus a debrief about the easy strategies you can start today to start shrinking your risk for prediabetes and type 2.

What This Prediabetes Study Found

Weight is just one of many risk factors for prediabetes and type 2 diabetes, the CDC says, so the scientists involved in this new study say it's time to stop giving that metric such priority. People who fall into the "normal" or even "underweight" BMI categories can still have prediabetes or type 2 diabetes. Plus, the risk rates for these blood sugar-related conditions appear to be distributed unevenly across certain populations. A December 2019 study published in the JAMA found that type 2 and prediabetes rates are most common among those who are Black, Hispanic and Asian, and research suggests that individuals with these backgrounds may develop type 2 or prediabetes at a lower BMI.

For this new study, researchers analyzed data from the National Health and Nutrition Examination Surveys (NHANES), a large pool of individuals who share health data and are said to represent a nationally-representative sample of American adults. They looked at how many cases of prediabetes and type 2 might be diagnosed under a variety of screening scenarios, including if the medical field followed the 2021 USPSTF suggestions of screening 35 to 70 year olds with a certain BMI. Lowering the age from 40 to 35 resulted in nearly 14 million more people being identified as having either condition; with the diagnosis differential being most impactful among those of Hispanic descent.

If all adults between 35 to 70 were screened—regardless of BMI—even more cases could be caught early, the researchers found. Screening based on age rather than age and BMI would streamline the process, suggests study author Matthew O'Brien, MD, an associate professor of medicine and preventive medicine at Northwestern University Feinberg School of Medicine. Plus, since we're learning more and more by the month about how weight isn't the number one factor in reducing health risks.

If doctors and their patients can team up to address elevated blood sugar during prediabetes, the individual at-risk for type 2 has a much better chance to pump the breaks and integrate lifestyle choices that can slow—or even prevent—the condition from becoming full-blown diabetes.

"Diabetes is a condition in which unacceptable racial and ethnic disparities persist," Dr. O'Brien said in a news release about the study. "That's why we need a screening approach that maximizes equity. If we can find everyone earlier, it helps us reduce these disparities and the bad outcomes that follow."

The Bottom Line

A new study suggests that all adults age 35 to 70, regardless of body weight, should receive a blood glucose test at their annual physical to increase the chances that they're able to catch prediabetes cases early. Prediabetes is often a "silent" condition, but it's one that can be turned around—if people are aware and can start implementing certain lifestyle shifts.

Regardless of whether the screening criteria changes as the result of this study, it might be worthwhile to ask your primary care doctor at your next physical if you should run a blood test to check your HbA1c levels (which measures your average blood sugar over the last 3 months). Whether you you have been diagnosed with prediabetes or not, these daily "do"s can help slash your risk for elevated blood sugar:

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