"Screening patients for diabetes based solely on their age and weight  a recommendation from a leading medical expert group  could miss more than half of highrisk patients according to a new Northwestern Medicine study of a nationwide sample. These limited screening criteria also missed more racial and ethnic minorities most notably Asians. Failing to screen highrisk adults could lead to delayed treatments to prevent type  diabetes or manage the condition for those who already have it possibly contributing to a worsening of the diabetes epidemic. Prediabetes and diabetes affect half of U.S. adults with an estimated cost of  billion per year. The United States Preventive Service Task Force USPSTF currently recommends that physicians screen patients for dysglycemia prediabetes or type  diabetes when they are  to  years old and are overweight or obese. By following this recommendation  percent of patients who had prediabetes or type  diabetes would not be screened. The study showed that screening patients using an expanded set of risk factors which the USPSTF suggests but does not formally recommend would identify most cases of prediabetes and type  diabetes. Only  percent of patients with prediabetes or diabetes would be missed if expanded screening criteria were used to make screening decisions the study found. The expanded criteria include a family history of diabetes history of gestational diabetes or polycystic ovarian syndrome or nonwhite race or ethnicity. This seems like a nobrainer to screen patients who have any of these additional risk factors said lead author Dr. Matthew OBrien assistant professor of medicine at Northwestern University Feinberg School of Medicine. By demonstrating how well these expanded criteria work in identifying patients with prediabetes and diabetes were proposing a better path for the USPSTF to strengthen its screening guidelines. The study was published today Friday April  in the Journal of General Internal Medicine. OBrien will be presenting his findings today at the Society for General Internal Medicine conference in Denver Colorado. This is the first study to report how these expanded screening criteria would perform in practice among a nationally representative sample of U.S. adults. The USPSTF has come under scrutiny for other screening recommendations most notably for breast cancer. But there has been little attention focused on this groups most recent diabetes screening guideline. Intensive lifestyle programs and some medications have been proven to prevent or delay type  diabetes among adults with prediabetes. A large volume of research over the last three decades has demonstrated that treating type  diabetes prevents lifethreatening complications such as heart attacks strokes and kidney failure. The earlier patients are diagnosed with these conditions the sooner they can begin to combat them OBrien said. AfricanAmericans and Latinos develop type  diabetes at younger ages so waiting until they are  years old to screen them is problematic OBrien said. In the study  percent of whites with prediabetes or type  diabetes were identified using the limited criteria compared to only  percent of AfricanAmericans and only  percent of Latinos. Asians are at high risk of developing diabetes even at a healthy weight. By following the limited guidelines and only screening patients who are overweight or obese approximately  percent of Asians with prediabetes or type  diabetes would be identified. That would leave  percent of Asians with prediabetes or diabetes undiagnosed until their next screening test which could occur years later. The study also touches on the financial implications of these guidelines. Under a provision in the Affordable Care Act all services recommended by the USPSTF must be fully covered by insurers. But OBrien said it is unclear whether insurers will be required to pay for diabetes screening if patients only meet the expanded criteria. This could be a particular problem for people of low socioeconomic status who are at high risk of developing diabetes and may be unable to pay for a screening test OBrien said.  The study was conducted collaboratively with the United States Centers for Disease Control and Prevention CDC using data collected every year from a nationally representative sample of U.S. adults. It builds on findings from a previous study OBrien conducted that incorporated electronic health record data from  adult primary care patients at community health centers in the Midwest and Southwest between  and .   Other Northwestern authors are senior author Dr. Ronald Ackermann and coauthors Mercedes Carnethon and Dr. Namratha Kandula. The other coauthors were from the CDC. Dr. Ronald Ackermann is the studys senior author. The study was funded by grants RDK RHL and ULITR from the National Center for Health Statistics of the National Institute of Health."