Current guidance on type 2 diabetes recommends a multifactorial approach to management, addressing diet, lifestyle, blood glucose, blood pressure and blood lipids. Given this, should we screen people for type 2 diabetes and get an early start on managing these risk factors?
A recent randomised trial assessed the effectiveness of early intensive multifactorial management on outcomes in people with type 2 diabetes detected by screening. The study was reviewed by the National Prescribing Centre, who provide regular rapid reviews of recent publications.
The reviewers conclused that the study does not show evidence of benefits for routine screening for type 2 diabetes, or for early intensive multifactorial management of macrovascular and microvascular risk factors in people with type 2 diabetes.
You can read the full text of their review, and listen to a podcast of the reviewers discussing it, at the links below.
Users of this podcast should consider:
- Whether the reviewers did enough to evaluate the potential for bias in the trial.
- Whether there were enough patients to show a significant benefit.
- In terms of the clinical question, does this study represent absence of evidence rather than evidence of absence?
- The applicability of the findings to their own practice.
- National Prescribing Centre. No significant benefits for early detection and intensive multifactorial management of type 2 diabetes. Rapid Review, September 2011. Podcast also available.
- Griffin SJ, et al. Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial. Lancet 2011;378:156–67 (login required).