title: Assessment of laboratory methods for detection of unsuspected diabetes in primary health care.
abstract: In order to assess different methods for early detection of unsuspected diabetes, urine and venous blood samples were collected at random from 1082 patients visiting a primary health care centre in southern Sweden. Blood glucose was analysed by the hexokinase method along with the Dextrostix-Eyetone reflectance meter. Urine glucose was determined by Clinistix, Diastix, Neostix, Rediatest, Clinitest and quantitatively by the hexokinase method. Patients fulfilling the criteria of a positive screen were subjected to a diagnostic investigation with an oral glucose tolerance test. Out of 89 positive screenees, 37 patients were classified as diabetics, showing a prevalence of diabetes in the study population of 3.4% according to the WHO criteria. Impaired glucose tolerance was found in 14 patients. In a control group of 56 patients, randomly selected among negative screenees, no cases of diabetes were found. Random blood glucose measurement by the hexokinase method, using 7 mmol/l as a screening level, had a significantly higher sensitivity (95%) than all urine glucose methods (59-30%) with comparable specificity (97-99%). Use of the Dextrostix-Eyetone reflectance meter resulted in a decrease in sensitivity to 75% without any change in specificity or predictability, compared with the hexokinase method. Urine testing for glucose was found to be a suboptimal method for early case finding of diabetes among patients receiving primary health care.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000652:urine; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D005188:False Negative Reactions; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006029:Glycosuria / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011934:Reagent Strips
chemical_list: D001786:Blood Glucose; D011934:Reagent Strips; D001205:Ascorbic Acid