Diabetes: New Guidelines on Screening and Diagnosis

D'Arcy Little, MD, CCFP
York Community Services, Toronto and
Department of Family Medicine, Sunnybrook Campus of Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario

Diabetes mellitus, a metabolic disease characterized by hyperglycemia secondary to defective insulin secretion and/or action, is an extremely common, chronic illness with a high burden of potentially preventable complications. It is a leading cause of coronary artery disease, peripheral vascular disease, kidney failure, peripheral neuropathy and new-onset blindness. A full five percent of Canadians have been diagnosed with the disease, and this percentage is predicted to translate into 2.2 million cases by the year 2000. However, statistics from the United States suggest that for every person diagnosed with diabetes, another has the disease and remains undiagnosed. Appropriate screening for diabetes provides the means to identify those undiagnosed individuals who may benefit from earlier intervention.

The terms insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetes were eliminated in favour of the terms "Type 1" and "Type 2" diabetes in an effort to emphasize pathogenesis over treatment in disease diagnosis.