Screening and epidemiology

Prediabetes is associated with an increased risk of all-cause mortality and cardiovascular disease, both in the general population and in individuals with pre-existing atherosclerotic cardiovascular disease. Hemoglobin A(1c) (HbA(1c)) testing can shorten the time to diabetes diagnosis, and earlier blood glucose control can help to reduce diabetes complications. Diabetes risk scores are not sufficient as a sole intervention for prevention. Contrary to the positive trend of decreasing incidence rates of type 2 diabetes in the elderly population in Germany, an increased incidence of type 2 diabetes in 20-39 year olds is of concern. Type 2 diabetes mortality rates have decreased by one-third over the past two decades. Comprehensive management of cardiovascular risk factors has contributed to lowering cardiovascular mortality. Improvements in cancer mortality among people with diabetes have been comparatively small. Cancer is now the leading cause of death in people with diabetes. Reducing modifiable risk factors (e.g., obesity, smoking) and raising awareness of screening for common cancers are relevant to further reducing the individual and societal burden of diabetes.