“To
Screen or Not to Screen for Type I Diabetes”
Desmond
Schatz MD Type
1 diabetes occurs when cells of the immune system attack insulin-producing
beta cells in the pancreas. Because all of their beta cells are
destroyed, type 1 diabetics are dependent on insulin injections
to control their blood sugar levels. The peak time for developing
type 1 diabetes is during puberty, although it can occur at any
age. The incidence of type 1 diabetes is increasing worldwide and
the disease is an onerous burden both to the individual and to society.
In the U.S. alone, this disorder affects 700,000 people and
is the most common chronic metabolic disorder in children. From
a public health point of view, it would seem that screening for
type 1 diabetes is the right thing to do, but some in the medical
community have pointed out that screening tests have a low positive
predictive value and that predicting the disease without a primary
prevention capability raises ethical considerations because of induced
stress, lifestyle changes, cost and potential effects on insurability.
Additionally, they say, the lack of effective intervention programs
to prevent the disease calls in the question of enacting any large-scale
population screening. The
authors of “To Screen or Not to Screen for Type I Diabetes?” are
Desmond Schatz MD, and Jin-Xiong She, both from the University of
Florida in Gainsville; and Jeffrey Krischer, from the Lee Moffit
Cancer Research Center and Research Institute, Tampa, Fla. Their findings were presented at the 54th Annual
Meeting of the American Association for Clinical Chemistry (AACC).
AACC (http://www.aacc.org/) is the scientific organization
for clinical laboratory professionals, physicians, and research
scientists. Their primary
commitment is the understanding of laboratory testing to identify,
monitor and treat human disease.
Dr.
Schatz suggests that there are important reasons to screen for the
disease before symptoms arise:
The
researchers conclude that screening in the context of well-designed
research studies must continue.
Once a safe and efficient intervention program is designed,
say the researchers, screening could begin on a large scale basis. Desmond
Schatz MD graduated
from University of the Witwatersrand,
South Africa and has achieved international recognition for his
work on the prediction and prevention of Type 1 diabetes. He was
pediatric resident at the University of Florida. Between the years
of 1986 and 1989 he was paediatric endocrinology fellow at that
university. Dr Schatz was appointed assistant professor and since
1994 has been an associate professor in the department of pediatric
endocrinology. He has published widely in his field. He has appeared
in ‘Best Doctors in America’ and in the American ‘Who's Who’ and
has been invited to a number of international conferences. He is
a member of many societies and of community organizations. He is
presently on the executive committee of the International Diabetes
Immunotherapy Group. The AACC is an international scientific/medical society of clinical laboratory professionals, physicians, research scientists and others involved with clinical laboratory medicine, science and related disciplines. Founded in 1948, the society has 10,000 members; a staff of more than 50 manages the Association's Washington, DC, and Charlottesville, VA offices. To
learn more about the AACC visit http://www.aacc.org/default.asp
|
|
