Identifying individuals at risk for the development of type 2 diabetes mellitus.
OBJECTIVE
To describe a population-based approach to the identification of individuals at high risk for the development of type 2 diabetes mellitus (DM).


METHODS
A prospective analysis of the incidence of DM in low- and high-risk groups.


METHODS
Questions associated with the risk of developing DM were incorporated into a health risk assessment (HRA), and health plan members were invited to complete the HRA as part of worksite health promotion efforts or medical clinic visits. Points were applied to the risk factors for DM, and individual HRA responders were assigned to low- or high-risk groups. A total of 16 427 members completed the HRA. To assess the incidence of new cases of DM, follow-up time was up to 4.8 years (mean, 2.55 years). New-onset DM cases were identified using International Classification of Diseases, Ninth Revision, coding for DM during the timeframe subsequent to HRA completion.


RESULTS
The incidence of new DM at the end of the study was 3.5% in the high-risk group and 0.7% in the low-risk group (P < .001).


CONCLUSIONS
Identification of individuals at risk for DM using this HRA approach increases by 5-fold the likelihood that the targeted risk reduction efforts will reach the right individuals. This approach allows for resource-efficient targeted intervention efforts designed to reduce the incidence of new DM cases.
Pearson
Teresa L
TL
Partners for Better Health Integration, Center for Health Promotion, HealthPartners, 8100 34th Avenue South, Minneapolis, MN 55440-1309, USA. teresa.l.pearson@healthpartners.com
Pronk
Nicolaas P
NP
Tan
Agnes W H
AW
Halstenson
Cindy
C
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000145:classification / Q000453:epidemiology*; D005260:Female; D006293:Health Promotion; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D015146:Midwestern United States / Q000453:epidemiology; D011446:Prospective Studies; D018570:Risk Assessment / Q000145:classification / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors