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Defeat Diabetes
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Free Screenings Can Show One in Four Has Hidden Prediabetes or Diabetes

Posted: Sunday, November 13, 2011

Free screening by trained volunteers can pick up cases of dysglycemia and other diabetic conditions in the general population.
 
Mona Boaz, PhD, of E. Wolfson Medical Center in Holon, and colleagues, reported that about 25% of healthy people who opted into a free screening at one hospital were found to have either dysglycemia or undiagnosed type 2 diabetes.

Boaz stated that, "It was astounding that more than 20% of people screened had impaired glucose tolerance, and that another 4% had type 2 diabetes but they didn't know it."  She added that the screening program was easy and inexpensive, especially because it was run by unpaid volunteers. Previous studies have shown that volunteers can be trained to run public diabetes, dysglycemia, and hypertension screenings.

Given the rising prevalence of obesity, Boaz said there's an urgent need for diabetes prevention, particularly with regard to lifestyle intervention and early detection.

So to determine the incidence of dysglycemia and diabetes among non-hospitalized individuals in a hospital setting, the researchers set up a free screening station in a central location at their hospital. Trained volunteers measured height, weight, blood glucose, and blood pressure. None of the patients were fasting at the time of the screen. Participants were asked if they'd ever been diagnosed with diabetes.

A total of 1,401 individuals with a mean age of 53 were screened; 228 reported having known diabetes and 136 reported having known hypertension. For the screening study, normoglycemia was defined as a glucose level of <140 mg/dL. Dysglycemia was defined as 140 to 190 mg/dL and diabetes was defined as ˇÝ200 mg/dL.

Among the 1,173 patients without known type 2 diabetes, the volunteer screeners found dysglycemia in 21.1% of them, and detected full-blown type 2 diabetes in 4.3%. Boaz noted that the numbers suggest the true incidence of undiagnosed type 2 diabetes and dysglycemia in the general population is likely an underestimate.

Compared with those who had normal glycemia, those who were dysglycemic were significantly older (P<0.001), had significantly higher blood glucose (P<0.001), body mass index (BMI; P<0.001), and systolic blood pressure (P<0.004).

Patients who were newly diagnosed with type 2 diabetes had significantly higher blood sugar levels than non-diabetics (P<0.001), but they didn't differ significantly in terms of age, BMI, or blood pressure. Boaz said this is likely a function of the small number of newly identified diabetes cases.

She cautioned that study did have some limitations. Participants opted to participate in the screening program, although they did screen over a thousand people. Also, screening was done in a hospital setting, which increased the chances that the patient was there because, "they have a suspicion that something isn't right."

She also noted that the results may be different at other locations in the community -- such as a shopping center -- although, "you'll still have the self-selection."

Boaz added that in other unpublished data, when the study was repeated in 4,000 patients, the 20% dysglycemia rate was slightly attenuated to about 17%.

Her group concluded that early detection can trigger early intervention, and has the potential to ultimately reduce morbidity and mortality related to diabetes.

  • Practice Pearls:
    Explain that free screening by trained volunteers can pick up cases of dysglycemia and other diabetic conditions in the general population.
  • Note that compared with those who had normal glycemia, those who were dysglycemic were significantly older, and had significantly higher blood glucose, body mass index, and systolic blood pressure.
  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Source: http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=11733&catid=53&Itemid=8, Boaz M, et al "Random examination of blood glucose in adults by trained volunteers in a hospital setting" WCIR 2011.

 
 
 
 
 
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