It turns out that there are already pretty good ways to test for diabetes, and although different authorities have different recommendations about who would benefit from screening, all agree that screening is important, as a huge number of people are at risk.

Diabetes may not have symptoms early in its course-which is why docs screen to catch it early. Unchecked, it can leave you fatigued and with vision problems, kidney failure, an increased risk of heart disease, and ED.

To avoid this kind of damage, its best to try to prevent diabetes if possible, or at least find it in its earliest stages (called prediabetes) so that a person can be more aggressive in preventing overt diabetes. People with prediabetes are likely to develop overt diabetes within ten years unless they take steps to prevent it. Its estimated that there are 86 million(!) people in the US with prediabetes, 90 percent of whom are unaware of it.

Clues youre at risk for diabetes

So, without knowing your genetic code, how do we know who is at risk? There are many clues you dont need to pay $199 to find out:

• Being overweight or obese. This is the biggest risk factor in the population, and the main reason for the epidemic of diabetes. What exactly constitutes the weight cutoff varies by guideline, but a BMI over 25 is commonly used.
• Family history of diabetes-especially if its in a parent or sibling.
• Age over 45, in the presence of other risk factors.
• People who have taken medications which increase risk: glucocorticoids (prednisone and related drugs) or antipsychotic drugs.
• Sedentary people (who dont get the recommended 30 minutes of moderate physical activity a day).
• People with medical conditions indicating risk, including high blood pressure (higher than 140/90 or on medication); low HDL cholesterol (less than 35 mg/dL) or triglycerides (higher than 250 mg/dL); fatty liver; acanthosis nigricans (a skin finding, more common in people with darker skin, of dark, velvety-appearing skin on the back of the neck, groin, or underarms); sleep disorders (in the presence of other risk factors), such as obstructive sleep apnea.
• People in at-risk ethnic groups (black, Native American, Hispanic, Asian-American, Native Hawaiian or Pacific Islander) in the presence of other risk factors.
• Anyone who has already had abnormal blood sugar results.
• The women in your life is also at higher risk if she had a very large baby, had gestational diabetes, or has polycystic ovarian syndrome.

When there are enough risk factors to screen for diabetes, I would recommend a visit with your friendly health care professional to get screened. Screening tests may be a simple blood sugar check; an A1c test (which looks at blood sugar over the last two months); and the most sensitive but least used of all, the oral glucose tolerance test. If you have actual symptoms of diabetes, including blurry vision, feeling thirsty or like you need to urinate all the time, have numbness or pain in the hands or feet or are feeling fatigued, you need to be tested sooner rather than later.

Back to 23andMe

What is not yet clear is how often someone will be identified by 23andMe as being at risk who otherwise wouldnt meet any of the extensive criteria for screening above. And for those who are identified as at-risk by genetic testing but wouldnt otherwise meet the criteria, how often are they found to be diabetic or pre-diabetic? Until I see that information, I cant recommend spending money on the DNA test.