Table 2.
Criterion | Satisfied |
---|---|
The condition sought should be an important health problem | Yes Type 1 diabetes is an important health problem. Whilst early screening does not currently allow us to institute preventative therapy, it may prevent comorbidity associated with late presentation |
There should be an accepted treatment for patients with recognised disease | Yes People at risk will be provided with education until they are formally diagnosed with diabetes, at which time they will be initiated on insulin. Early education and initiation of insulin are likely to be acceptable and effective |
Facilities for diagnosis and treatment should be available | Yes Most healthcare facilities have access to phlebotomy and oral glucose challenge facilities. Samples can be sent to reference centres nationally for analysis |
There should be a recognisable latent or early symptomatic stage | Yes Latent and early symptomatic phase can be detected through autoantibody and glucose challenge |
There should be a suitable test or examination | Yes Peripheral blood tests for antibodies and oral glucose challenge |
The test should be acceptable to the population | Not known The psychological consequences of awareness of high risk of a chronic disease for which there is no cure is not known |
The natural history of the condition, including development from latent to declared disease, should be adequately understood. | Not known Natural history remains to be fully elucidated, different rates of progression remain to be understood. Age, ethnicity and environment appear to influence natural history and these effects remain to be elucidated |
There should be an agreed policy on whom to treat as patients | Yes People fulfilling standard WHO criteria for diabetes will be treated as diabetic |
The cost of case-finding should be economically balanced in relation to possible expenditure on medical care as a whole | Not known |
Case-finding should be a continuing process and not a ‘once and for all’ project | Yes A long-term programme can be implemented nationally |