Random blood glucose as a screening test for diabetes in a biethnic population.
Screening asymptomatic subjects for diabetes is often undertaken using a random capillary whole blood sample for glucose estimation. The test characteristics of this method for screening were assessed using a glucose oxidase method among 3425 Europeans and 3469 South Asians who gave such a sample during the Coventry Diabetes Study, a house-to-house diabetes prevalence study. Glucose tolerance test were performed on those with a high blood glucose and 10% of others. Previously undiagnosed diabetes was found in 73 Europeans and 110 South Asians. If the random glucose was > or = 7.0 mmol l-1, 8.0% of Europeans and 6.7% of South Asians would need a further diagnostic test and the sensitivity of this cut-off was 51.7 (95.0% CI: 43.5-59.9)% in Europeans and 68.4 (60.6-76.2)% in South Asians. Sensitivity was increased in South Asians but not Europeans by defining the time since last meal (South Asians < 2 h: 83.9 (72.3-92.0)%; > or = 2 h: 54.9 (42.7-66.8)%). Sensitivity was poorest among Europeans aged > or = 65 years (40-64 years 69.0 (49.2-84.7)%, > or = 65 years 49.4 (38.2-60.6)%). Screening asymptomatic individuals using an isolated capillary random whole blood glucose measure is a poor test for diabetes, although slight improvement can be obtained among South Asians by testing within 2 h of a meal.
Simmons
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Sheikh Rashid Diabetes Unit, Radcliffe Infirmary, Oxford, UK.
Williams
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D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D004739:England / Q000453:epidemiology; D005060:Europe / Q000208:ethnology; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011897:Random Allocation; D012680:Sensitivity and Specificity
D001786:Blood Glucose