Jennifer H Howse1, Steve Jones, A Pali S Hungin. 1. Centre for Integrated Healthcare Research, School of Medicine and Health, Wolfson Research Institute, Durham University, Stockton-on-Tees, UK. j.h.howse@durham.ac.uk
Abstract
BACKGROUND: Unconventional settings, outside general medical practice, are an underutilised resource in the attempt to identify the large numbers of people with undiagnosed diabetes worldwide. AIM: The study investigated the feasibility of using optometry practices (opticians) as a setting for a diabetes screening service. DESIGN AND SETTING: Adults attending high street optometry practices in northern England who self-reported at least one risk factor for diabetes were offered a random capillary blood glucose (rCBG) test. Those with raised rCBG levels were asked to visit their GP for further investigations. RESULTS: Of 1909 adults attending practices for sight tests, 1303 (68.2%) reported risk factors for diabetes, of whom 1002 (76.9%) had rCBG measurements taken. Of these, 318 (31.7%) were found to have a rCBG level of ≥6.1 mmol/l, a level where further investigations are recommended by Diabetes UK; 1.6% of previously undiagnosed individuals were diagnosed with diabetes or pre-diabetes as a result of the service. Refining the number of risk factors for inclusion would have reduced those requiring screening by half and still have identified nearly 70% of the new cases of diabetes and pre-diabetes. CONCLUSION: Screening in optometric practices provides an efficient opportunity to screen at-risk individuals who do not present to conventional medical services, and is acceptable and appropriate. Optometrists represent a skilled worldwide resource that could provide a screening service. This service could be transferable to other settings.
BACKGROUND: Unconventional settings, outside general medical practice, are an underutilised resource in the attempt to identify the large numbers of people with undiagnosed diabetes worldwide. AIM: The study investigated the feasibility of using optometry practices (opticians) as a setting for a diabetes screening service. DESIGN AND SETTING: Adults attending high street optometry practices in northern England who self-reported at least one risk factor for diabetes were offered a random capillary blood glucose (rCBG) test. Those with raised rCBG levels were asked to visit their GP for further investigations. RESULTS: Of 1909 adults attending practices for sight tests, 1303 (68.2%) reported risk factors for diabetes, of whom 1002 (76.9%) had rCBG measurements taken. Of these, 318 (31.7%) were found to have a rCBG level of ≥6.1 mmol/l, a level where further investigations are recommended by Diabetes UK; 1.6% of previously undiagnosed individuals were diagnosed with diabetes or pre-diabetes as a result of the service. Refining the number of risk factors for inclusion would have reduced those requiring screening by half and still have identified nearly 70% of the new cases of diabetes and pre-diabetes. CONCLUSION: Screening in optometric practices provides an efficient opportunity to screen at-risk individuals who do not present to conventional medical services, and is acceptable and appropriate. Optometrists represent a skilled worldwide resource that could provide a screening service. This service could be transferable to other settings.
Authors: M I Harris; K M Flegal; C C Cowie; M S Eberhardt; D E Goldstein; R R Little; H M Wiedmeyer; D D Byrd-Holt Journal: Diabetes Care Date: 1998-04 Impact factor: 19.112
Authors: I Krass; B Mitchell; P Clarke; M Brillant; R Dienaar; J Hughes; P Lau; G Peterson; K Stewart; S Taylor; J Wilkinson; C Armour Journal: Diabetes Res Clin Pract Date: 2006-08-01 Impact factor: 5.602