This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in JAMA

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Simulation modeling is a powerful and appropriate tool for examining the possible impact of screening for type 2 diabetes, and we agree with the conclusion of the CDC Diabetes Cost-Effectiveness Study Group that "the selection of appropriate target populations for screening should consider factors in addition to the prevalence of diabetes."¹ However, we are concerned that their model disregards some of the important factors that influence outcomes.

First, the authors assume that screening merely brings forward the date of diagnosis. Their model and their estimate of the time between onset and clinical diagnosis are based on studies of clinically diagnosed cases. However, a population identified by screening would include many people whose condition would never be clinically apparent and who will die, mainly of cardiovascular disease (CVD), before clinical diagnosis and long before they would develop long-term microvascular complications. The model therefore may overestimate the risks of . . . [Full Text of this Article]