How can we identify candidates at highest risk – to screen or not to screen?

Type 2 diabetes (T2D) causes a large economic and health-care burden globally. This article summarizes the benefits and unsolved questions of screening for T2D. Many T2D risk assessment tools have been developed. Furthermore, current evidence has shown that T2D can be prevented by lifestyle interventions, justifying T2D screening. However, information is scarce on the long-term impact of T2D screening regarding health outcomes such as cardiovascular disease. Moreover, it is not certain whether health-care facilities and health-care staff are capable of implementing screening activities and subsequent interventions among high-risk individuals; lifestyle management tasks in particular are often not among the best skills that health-care personnel possess. Also, there is a lack of evidence for the periodicity of population-wide screening activities. As national health-care systems increasingly implement T2D screening, we may receive in the near future answers to some of our remaining research questions to fully assess the benefits and disadvantages of screening.