{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T19:06:25Z","timestamp":1748891185092,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,6,14]],"date-time":"2020-06-14T00:00:00Z","timestamp":1592092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["4T35AG029795\u201011"],"award-info":[{"award-number":["4T35AG029795\u201011"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R03AI133172"],"award-info":[{"award-number":["R03AI133172"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30 DK092949","P30DK111024","R21DK099716","U01 DK091958","U01 DK098246"],"award-info":[{"award-number":["P30 DK092949","P30DK111024","R21DK099716","U01 DK091958","U01 DK098246"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01 MD013420"],"award-info":[{"award-number":["R01 MD013420"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["PHILLI12A0"],"award-info":[{"award-number":["PHILLI12A0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the U.S. population\u2010level impact of two alternatives for initial type 2 diabetes screening [opportunistic random plasma glucose (RPG) &gt; 6.7\u00a0mmol\/l and a 1\u2010h 50\u2010g glucose challenge test (GCT) &gt; 8.9\u00a0mmol\/l] compared with American Diabetes Association (ADA)\u2010recommended tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a sample (<jats:italic>n<\/jats:italic> = 1471) from the National Health and Nutrition Examination Survey (NHANES) 2013\u20132014 that represented 145 million U.S. adults at high risk for developing type 2 diabetes, we simulated a two\u2010test screening process. We compared ADA\u2010recommended screening tests [fasting plasma glucose (FPG), 2\u2010h 75\u2010g oral glucose tolerance test (OGTT), HbA<jats:sub>1c<\/jats:sub>] vs. initial screening with opportunistic RPG or GCT (followed by FPG, OGTT or HbA<jats:sub>1c<\/jats:sub>). After simulation, participants were entered into an individual\u2010level Monte Carlo\u2010based Markov lifetime outcomes model. Primary outcomes were representative number of U.S. adults correctly identified with type 2 diabetes, societal lifetime costs and quality\u2010adjusted life years (QALYs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In NHANES 2013\u20132014, 100 individuals had undiagnosed diabetes [weighted estimate: 8.4 million, standard error (<jats:sc>se<\/jats:sc>): 1.1 million]. Among ADA\u2010recommended screening tests, FPG followed by OGTT (FPG\u2013OGTT) was most sensitive, identifying 35 individuals with undiagnosed diabetes (weighted estimate: 3.2 million, <jats:sc>se<\/jats:sc>: 0.9 million). Four alternative screening strategies performed superior to FPG\u2013OGTT, with RPG followed by OGTT being the most sensitive overall, identifying 72 individuals with undiagnosed diabetes (weighted estimate: 6.1 million, <jats:sc>se<\/jats:sc>: 1.0 million). There was no increase in average lifetime costs and comparable QALYs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Initial screening using opportunistic RPG or a GCT may identify more U.S. adults with type 2 diabetes without increasing societal costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14330","type":"journal-article","created":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T05:33:15Z","timestamp":1590384795000},"page":"1935-1943","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Alternative type 2 diabetes screening tests may reduce the number of U.S. adults with undiagnosed diabetes"],"prefix":"10.1111","volume":"37","author":[{"given":"R. S.","family":"Dadwani","sequence":"first","affiliation":[{"name":"Pritzker School of Medicine Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. R.","family":"Skandari","sequence":"additional","affiliation":[{"name":"Imperial College Business School Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. S.","family":"GoodSmith","sequence":"additional","affiliation":[{"name":"Pritzker School of Medicine Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. S.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism Department of Medicine Emory School of Medicine Atlanta GA USA"},{"name":"Atlanta VA Medical Center Decatur GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-1476","authenticated-orcid":false,"given":"M. K.","family":"Rhee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism Department of Medicine Emory School of Medicine Atlanta GA USA"},{"name":"Atlanta VA Medical Center Decatur GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0124-4325","authenticated-orcid":false,"given":"N.","family":"Laiteerapong","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,14]]},"reference":[{"volume-title":"National Diabetes Statistics Report, 2020","year":"2020","author":"Centers for Disease Control and 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