Preventive Healthcare Services

This paper discusses the preventive screening and diagnostic guidelines for patients with Type 2 Diabetes Mellitus. It covers the screening application, risk factors, risk assessments, testing interval, and screening test recommendations.

Running head: PREVENTIVE HEALTHCARE SERVICES
PREVENTIVE HEALTHCARE SERVICES
Name of the Student:
Name of the University:
Author note:

1PREVENTIVE HEALTHCARE SERVICES
Introduction
The USPSTF comprises of a panel of clinical health professionals specializing in the
prevention and diagnosis of harmful disease conditions. The following paper discusses
preventive screening and diagnostic guidelines for patients who are admitted to a healthcare
clinic and are suffering from Type 2 Diabetes Mellitus (United States Preventive Services Task
Force, 2019).
Discussion
Guideline Explanation
As per the USPSTF recommendations, the guideline explains that for a patient suffering
from Type 2 Diabetes Mellitus, there must be screening undertaken in the form of regular
monitoring of abnormal levels of blood glucose. Patients who are also overweight or obese along
with suffering from type 2 diabetes mellitus must also undergo cardiovascular risk assessment as
per the guidelines outlined by USPSTF, especially adults who are in the age group of 40 to 70
years. For patients with uncontrolled diabetes and glucose levels, health professionals must act in
accordance to the USPSTF guidelines and refer the patient to additional interventions in the form
of intense behavioral counseling sessions to inculcate healthy habits of exercise and nutritious
diet (United States Preventive Services Task Force, 2019).
Screening Application
As observed from the guidelines, the screening must be applied upon patients suffering
from type 2 diabetes mellitus, with uncontrolled blood levels of glucose coupled with being in
possession of an abnormal weight, considering the hyperglycemic effects exerted the same.

2PREVENTIVE HEALTHCARE SERVICES
Considering the long term symptomatic effects of abnormal lipid metabolism and possible
endothelial adiposity in uncontrolled diabetes, the screening must also be applied in diabetic
patients in the form of a cardiac assessment involving examination of heart rate, blood pressure,
palpitations, respiratory rates and examination of jugular venous pressures (Selph et al., 2015).
Insulin resistance and disrupted lipid metabolism can be corrected by adhering to adequate
exercise and nutritional guidelines and hence must be applied on patients, especially those with
faulty lifestyle and dietary habits (Anderson et al., 2016).
Epidemiology of Guidance and Patient Population Description
According to the Center for Disease Control and Prevention, type 2 diabetes mellitus
affects 100 million Americans, out of which 9.4 % are suffering from diabetes and 84.1 million
are suffering from pre-diabetes or impaired glucose tolerance. Out of this, 17 % Americans in the
ages 45 to 64 years and 25 % of Americans in the ages 65 years or beyond were suffering from
the same. In the year 2015, the seventh highest causative factor of death for Americans was
found to be type 2 diabetes. As observed by the Obesity Society, obesity was found to be an
underlying causative factor behind 90% of patients inflicted with diabetes. Adherence to
sedentary lifestyle and consumption of processed food especially in the form of sugary beverages
have been found to be a major contributory factor among the diabetic patient population (Centers
for Disease Control and Prevention, 2017).
Risk Factors
According to the Centers for Disease Control and Prevention, an individual is at risk of
acquiring type diabetes mellitus if he or she has pre-diabetes, is aged 45 years or beyond, is
abnormally overweight, has a family history of diabetes, engages in less than thrice a week of
physical activity, has given birth to an infant weighing 9 pounds or more or have suffered from

3PREVENTIVE HEALTHCARE SERVICES
gestational diabetes or belong to the ethnic groups of Indian, Hispanic, African-American,
Alaska Native or American Indian (Chamberlain et al., 2016).
Risk Assessments
Individuals with a non clinical background can evaluate their risk of acquiring type 2
diabetes by undertaking the Diabetes Risk Assessment Tools outlined by the American Diabetes
Association and the National Institute of Diabetes and Digestive and Kidney Diseases (Micha et
al., 2017). Additional risk assessment tools include calculation of Body Mass Index, monitoring
of fasting blood glucose levels and lipid profile and being observant in the presence of diabetic
symptoms such as extreme thirst and hunger, fatigue, frequent urination especially at night,
genital itching and delayed wound healing (American Diabetes Association, 2017).
Testing Interval
Patients who are administering multiple daily insulin injections may be required to
undertake fasting glucose monitoring during bedtime and prior to meals for patients. For patients
using long acting insulin, testing may be conducted at intervals prior to breakfast as well as
dinner (Wayne et al., 2015).
Screening Test Recommendations
For the screening of fasting and post prandial blood glucose levels relevant for type 2
diabetes mellitus, it is recommended that the individual undertakes fasting blood glucose testing
on an empty stomach while post prandial blood glucose testing is recommended to be undertaken
2 hours post a meal (Siu, 2015).

4PREVENTIVE HEALTHCARE SERVICES
Conclusion
Hence, it can be concluded that the screening guidelines recommended by the United
States Preventive Services Task Force provides a comprehensive and effective diagnostic tool for
assessment of patients suffering from type 2 Diabetes Mellitus. Adhering to regular monitoring
of blood glucose levels followed by adequate diet and exercise will aid in the effective
management of type 2 Diabetes Mellitus.

5PREVENTIVE HEALTHCARE SERVICES
References
American Diabetes Association. (2017). 2. Classification and diagnosis of diabetes. Diabetes
care, 40(Supplement 1), S11-S24. doi: https://doi.org/10.2337/dc17-S005.
Anderson, A. E., Kerr, W. T., Thames, A., Li, T., Xiao, J., & Cohen, M. S. (2016). Electronic
health record phenotyping improves detection and screening of type 2 diabetes in the
general United States population: A cross-sectional, unselected, retrospective study.
Journal of biomedical informatics, 60, 162-168. doi:
https://doi.org/10.1016/j.jbi.2015.12.006.
Centers for Disease Control and Prevention. (2017). New CDC report: More than 100 million
Americans have diabetes or prediabetes. Retrieved from
https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html
Chamberlain, J. J., Rhinehart, A. S., Shaefer, C. F., & Neuman, A. (2016). Diagnosis and
management of diabetes: synopsis of the 2016 American Diabetes Association standards
of medical care in diabetes. Annals of internal medicine, 164(8), 542-552. doi:
10.7326/M15-3016.
Micha, R., Peñalvo, J. L., Cudhea, F., Imamura, F., Rehm, C. D., & Mozaffarian, D. (2017).
Association between dietary factors and mortality from heart disease, stroke, and type 2
diabetes in the United States. Jama, 317(9), 912-924. doi: 10.1001/jama.2017.0947.
Selph, S., Dana, T., Blazina, I., Bougatsos, C., Patel, H., & Chou, R. (2015). Screening for type 2
diabetes mellitus: a systematic review for the US Preventive Services Task Force. Annals
of internal medicine, 162(11), 765-776. doi: 10.7326/M14-2221.

6PREVENTIVE HEALTHCARE SERVICES
Siu, A. L. (2015). Screening for abnormal blood glucose and type 2 diabetes mellitus: US
Preventive Services Task Force recommendation statement. Annals of internal medicine,
163(11), 861-868. doi: 10.7326/M15-2345.
United States Preventive Services Task Force. (2019). USPSTF A and B Recommendations - US
Preventive Services Task Force. Retrieved from
https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-
recommendations/
Wayne, N., Perez, D. F., Kaplan, D. M., & Ritvo, P. (2015). Health coaching reduces HbA1c in
type 2 diabetic patients from a lower-socioeconomic status community: a randomized
controlled trial. Journal of medical Internet research, 17(10). doi:
https://dx.doi.org/10.2196%2Fjmir.4871.