W A Scherbaum1, H-D Dicken, F Verheyen, T Baehring. 1. Deutsche Diabetes-Klinik, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heinrich-Universität Düsseldorf, Düsseldorf. scherbaum@ddz.uni-duesseldorf.de
Abstract
BACKGROUND AND OBJECTIVE: The detection of unknown cases of diabetes mellitus is of great medical and public health interest. In the present study a stepwise screening procedure was used to examine the effectiveness of a diabetes-risk questionnaire at a population level. PATIENTS AND METHODS: 58,254 insured persons (34,179 men and 24,075 women (55 years and older) enrolled in the Health Insurance "Techniker Krankenkasse" of Thuringia and the Duesseldorf area were contacted per mail to participate. 21,218 returned the questionnaire. They were contacted again and encouraged to participate in a medical check-up for early detection of diabetes. RESULTS: Data of 4,314 individuals (20.3%) who participated in the medical check-up were analysed. Their fasting blood glucose was measured (FBG, n=3,888) and, if necessary, they underwent an additional oral glucose tolerance test (OGTT, n=2,048). In 192 cases (4.5%) the general practitioner (GP) diagnosed manifest diabetes mellitus. In an additional 393 patients (9.1%) an impaired glucose tolerance was found. Analysis of documented blood glucose measurements suggested a manifest diabetes mellitus in 3.5% (by OGTT) and 10.3% (by FBG), as well as an impaired glucose tolerance in 16.1% (by OGTT) and 36.6% (by FBG). CONCLUSIONS: These results demonstrate good effectiveness of the screening procedure among the participants of a medical check-up programme for early detection of diabetes mellitus and its precursors. However, the effectiveness of population-based diabetes screening with only a mailing of a risk questionnaire was unsatisfactory.
BACKGROUND AND OBJECTIVE: The detection of unknown cases of diabetes mellitus is of great medical and public health interest. In the present study a stepwise screening procedure was used to examine the effectiveness of a diabetes-risk questionnaire at a population level. PATIENTS AND METHODS: 58,254 insured persons (34,179 men and 24,075 women (55 years and older) enrolled in the Health Insurance "Techniker Krankenkasse" of Thuringia and the Duesseldorf area were contacted per mail to participate. 21,218 returned the questionnaire. They were contacted again and encouraged to participate in a medical check-up for early detection of diabetes. RESULTS: Data of 4,314 individuals (20.3%) who participated in the medical check-up were analysed. Their fasting blood glucose was measured (FBG, n=3,888) and, if necessary, they underwent an additional oral glucose tolerance test (OGTT, n=2,048). In 192 cases (4.5%) the general practitioner (GP) diagnosed manifest diabetes mellitus. In an additional 393 patients (9.1%) an impaired glucose tolerance was found. Analysis of documented blood glucose measurements suggested a manifest diabetes mellitus in 3.5% (by OGTT) and 10.3% (by FBG), as well as an impaired glucose tolerance in 16.1% (by OGTT) and 36.6% (by FBG). CONCLUSIONS: These results demonstrate good effectiveness of the screening procedure among the participants of a medical check-up programme for early detection of diabetes mellitus and its precursors. However, the effectiveness of population-based diabetes screening with only a mailing of a risk questionnaire was unsatisfactory.