To detect diabetes and heart disease early on, clinicians should focus on five key risk factors, according to a guideline released this week by the Endocrine Society.

The authors recommend screening for 1) a large amount of abdominal body fat, 2) low HDL cholesterol, 3) high triglyceride levels, 4) high blood pressure 5) and high blood sugar. 

Patients who have three or more of the risk factors should be regularly screened, they wrote. This is in addition to screening for other known risk factors such as LDL cholesterol levels, family history and smoking.

The updated recommendations, which focus on adults aged 40 to 70, reflect recent trial data on blood pressure and lipids. Recommendations for lifestyle and behavioral interventions and information about new medical treatment options are included.

The authors also place a special emphasis on waist measurement, and reported that there is currently not enough focus on this factor. 

“It’s essential to identifying patients at metabolic risk earlier and preventing more cases of heart disease and diabetes,” said James L. Rosenzweig, M.D., who helped develop the guideline. “We emphasize the importance of lifestyle, dietary and behavioral changes as the first line treatment. However, treatment with medication is appropriate if goals are not met with lifestyle changes alone.”

The guideline, “Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline,” has been published online and will appear in the September issue of The Journal of Clinical Endocrinology & Metabolism.