College of American Pathologists
Printable Version



Posted January 27, 2010

Overview Note

The prevalence of diabetes mellitus is increasing and is a major national health care concern. Lifestyle changes may decrease the incidence of diabetes in high risk individuals.


The College of American Pathologists recommends that all individuals be screened for diabetes at age 45 and if the blood glucose level is normal, re-screen at least every three years. Patients who are at high risk should consult with their physician and consider more frequent screening and at an earlier age.

Screening frequency should be the result of consultation between a patient and their primary care physician. Optimum treatment of the diabetic patient requires education of the patient and collaboration with the health care provider.

Information Highlights

  • Diabetes is a group of diseases marked by high levels of blood glucose resulting from decreased insulin production, how the body uses insulin, or both.
  • Pre-diabetes is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes.
  • There are 23.6 million children and adults in the United States, 7.8% of the population, who have diabetes.
  • While an estimated 17.9 million people have been diagnosed with diabetes, 5.7 million people (or nearly one quarter) do not know that they have the disease.
  • The total annual economic cost of diabetes in 2007 was estimated to be $174 billion.
  • While diabetes was the seventh leading cause of death listed on U.S. death certificates in 2006, diabetes is often underreported as a cause of death.
  • Overall, the risk for death among people with diabetes is about twice that of people without diabetes of similar age.
  • Diabetes is sub-classified into two major types; type 1 diabetes and type 2 diabetes.
    • Type 1, which is most often diagnosed in children. In type 1 diabetes there is a lack of production of insulin by the pancreas.
    • Type 2, which is the most common form of diabetes and is usually diagnosed in adults. In type 2 diabetes the pancreas produces insulin; however, the body does not respond to the insulin in an appropriate manner and insulin resistance develops.
  • Another form of diabetes is gestational diabetes, which occurs in pregnant women.
  • Patients with diabetes are at increased risk for a heart attack, stroke and atherosclerosis. Atherosclerosis is also commonly known as hardening of the arteries, blockage of the blood vessels, and blood vessel damage.
  • Diabetes affects many organ systems in the body. Undiagnosed diabetes can cause damage to the nerves, heart, eyes and kidneys. In addition, people with diabetes have a harder time fighting infections.

Risk Factors:

  • Being overweight is a major risk factor for type 2 diabetes. However, this means that you can reduce your risk by maintaining an appropriate weight and exercising regularly.
  • Having a family background of African American, Alaskan Native, American Indian, or Asian American puts you at greater risk for developing adult onset or type 2 diabetes.
  • Other risk factors for diabetes are obesity, a family history, gestational diabetes during a pregnancy, and being over the age of 65.

Screening for Diabetes

  • To determine if a patient has pre-diabetes or diabetes, health care providers can conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT).
  • In patients diagnosed with type 1 diabetes, self-monitoring of blood glucose levels is recommended. In patients with type 2 diabetes, self-monitoring may also be recommended in some cases.

Treatment and Prevention

  • In patients who are diagnosed with pre-diabetes, lifestyle changes, such as losing weight and exercising, may reduce the risk for the development of diabetes.
  • Treatment of diabetes varies depending on the individual patient.
  • Patients with type 1 diabetes require insulin.
  • Oral medications are most commonly used in type 2 diabetes.
  • Home monitoring of blood glucose levels allows proper monitoring of prescribed therapies and alerts the patient and physician to any potential necessary adjustments in therapy.