A newly vetted set of BMI diagnosis thresholds can help clinicians catch diabetes earlier in higher-risk groups, investigators say.
The U.S. Preventive Services Task Force guidelines recommend screening for prediabetes and type 2 diabetes at a BMI of 25 kg/m² or greater for adults aged 35 to 70 years. For populations known to be at higher risk, such as Hawaiian/Pacific Islanders or Blacks, it suggests screening at an earlier age and at a lower BMI of 23 or greater.
In the current study, investigators sought to find more targeted BMI screening thresholds that would have the same benefits and harms to the threshold used in white adults. To do so, they also determined the diabetes prevalence at different BMIs for white, Asian, Black and Hispanic Americans.
The prevalence in Asian, Black and Hispanic Americans populations was higher than that in the white population, they found. And the equivalent BMI thresholds of 25 kg/m² in white Americans for each group were all lower, as follows: 20 for Asian Americans, less than 18.5 for Black Americans and 18.5 for Hispanic Americans.
Among U.S. adults aged 35 years or older, using these BMI thresholds when making clinical diabetes determinations would help ensure early diagnoses and prompt treatment across all racial and ethnic groups, the researchers said.
“Using screening thresholds specific to race/ethnicity has the potential to reduce disparities in diabetes diagnosis,” they concluded.
The study was published in the Annals of Internal Medicine.