@AnKing-Maintainers multiple suggestions asking to fix this
UW confirms: “Even in the absence of hypertension, screening is advised for patients age 35-70 with a BMI ≥25 (ie, overweight or obesity).” (Step 2 - 3807)
this is on my list of cards to address after step 2, but i’m pretty sure the first half is based on old uspstf recommendations too the “sustained blood pressure > {{c1::130/80}} mmHg” part
old rec link → Archived: Diabetes Mellitus (Type 2) in Adults: Screening | United States Preventive Services Taskforce.
new rec → Recommendation: Prediabetes and Type 2 Diabetes: Screening | United States Preventive Services Taskforce
The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions.
Grade B
There’s also the 2025 ADA guidelines which recommends screening ALL individuals ≥ 35 years of age regardless of BMI
Oh…correct you are sir. This does complicate things!
Looks like these societies are always going to differ slightly on exactly what they recommend. However, it sounds like none of them recommend screening based on HTN alone. By that token, one option would be to at least delete the BP part.
New card would be:
Screening for diabetes is recommended for
all patients with a sustained blood pressure > {{c1::130/80}} mmHg and forall overweight / obese patients ≥ {{c2::35}} years old
Alternatively, we could make the card specify the guidelines from each society, with something like:
Diabetes screening guidelines:
USPSTF: {{c1::all adults age 35-70 with a BMI of ≥ 25}}
ADA: {{c1::all adults age ≥ 35, regardless of BMI}} and/or {{c1::all adults with a BMI ≥ 25 plus ≥ 1 risk factors}}
^ and then the Extra could specify what the common risk factors are according to the ADA (e.g., HTN, HLD, PCOS, cardiovascular disease, first-degree relative with DM, member of high-risk group, etc.).
Thoughts anyone? Personally, I prefer the second option because it’s more comprehensive, and this seems like a pretty high-yield topic which would be worthy of a more difficult card.
The idea I had that was in my growing notes of things to address when I have time was to change 2 cards that cover this topic.
nid:1500925972834
this current card to cover the ADA guidelines of any adults over 35 years as cloze 1 and then any adult with >1 risk factor (helps since it already has a cloze 1 and cloze 2)
nid:1542995645796 this card currently says
Diabetes screening is recommended in adults age 35-70 who are {{c1::overweight / obese::population}}"
Change this slightly to focus on the USPSTF recommendations based on BMI. it helps that the card is already has cloze over weight too. Change could be to this
“USPSTF recommends routine diabetes screening in adults age {{c1::35-70::age range}} who are {{c1::overweight / obese::population}}”
Extra section for both cards would need to have
- If preDM/T2DM is normal repeat screening every 3 years
- Difference with ADA and USPSTF guidelines
My idea was big rewrites on two cards, so you can see why it was just left in my notes to deal with afterwards… mostly so I check all tagged QIDs first 