Diabetes guidelines

The recommendation from the Canadian Task Force on Preventive Health Care that screening for type 2 diabetes is not recommended, except in very high-risk patient groups, is certainly interesting.1 The suggestion that the CANRISK type 2 diabetes risk screening model be used prior to screening blood work is also interesting. Four of the 10 questions within this screening questionnaire demand knowledge of blood sugar levels. Understanding how one would operationalize this screening model without having already screened for the presence of elevated blood sugars is difficult.

Furthermore, when population demographics suggest that 50% of Canadians are either overweight or obese, that the vast majority of these people have substantial abdominal adiposity and that less than 5% of this population is physically active, the utility of screening only extremely high-risk populations does not seem to speak very well to the fundamental concept of prevention. If 100% of the population we are screening has the disease we are screening for, how does this constitute prevention?

Also, the document as published contains only very limited conflict of interest or duality of interest statements. The guideline developers have failed to acknowledge the inherent conflict of interest between guideline developers and those who pay for their time to develop guidelines. Is this an oversight?