A large study from Aarhus University, Denmark, showed that for individuals diagnosed with diabetes, screening is associated with a reduction in healthcare costs due to fewer admissions and doctor's visits and a reduction in prescribed medication
Health checks including diabetes risk assessment have been introduced in a number of countries. However, there are few population-based trials assessing the benefits, harms and costs of these screening programmes, and these have shown mixed results.
Between 2001 and 2006, a population-based cardiovascular and diabetes screening programme was introduced in five out of sixteen Danish counties. Over 150,000 individuals registered with 181 practices participating in the ADDITION-Denmark study were sent a diabetes risk score questionnaire, and if their score indicated moderate to high risk they were invited to attend for a diabetes test and cardiovascular risk assessment with their family doctor.
More than 27,000 attended for screening, and 1533 were diagnosed with diabetes during screening. A further 1,760,000 individuals were identified for a matched no-screening control group. Participants were followed for approximately six years following diagnosis until 31 December 2012, when national registers were searched for healthcare usage and healthcare cost.
The researchers found that those individuals with clinically-diagnosed diabetes were identified on average 2.2 years later than individuals whose diabetes was detected in the screening practices. Healthcare costs were significantly lower in the screening group compared with the no-screening control group, with an average annual difference in healthcare costs of €889 per individual with diabetes. The results have just been published in the scientific journal Diabetologia.
Lead author, Camilla Sortsø, says "While trials of population-based screening for type 2 diabetes have not demonstrated beneficial effects at the population level, we have previously shown that there are benefits for those found to have diabetes. This study contributes to our previous research by showing that early detection and treatment among individuals at high risk of type 2 diabetes has the potential to reduce costs."
The published results are based on the Danish part of the ADDITION study. The ADDITION study is a Danish initiated, international study with partners in Cambridge, UK and Utrecht, Holland.