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Screening for NIDDM: Why is there no national program?

Non-insulin-dependent diabetes mellitus (NIDDM) is a major clinical and public health problem in the U. S. The prevalence of NIDDM is 7% among all adults and reaches over 20% among those 65–74 years of age (1–3). NIDDM and insulin-dependent diabetes mellitus (1DDM) combined account for 50% of all nontraumatic amputations in the U. S., 15% of all blindness, and 35% of all end-stage renal disease (4). At least 50% of these events occur in NIDDM patients (5–7). Prevalence of neuropathy and ischemic heart disease in NIDDM and risk of death from cardiovascular disease is two to three times that of those without diabetes even after adjusting for other risk factors (8–13).