title: Population impact of strategies for identifying groups at high risk of type 2 diabetes.
abstract: BACKGROUND
  To assess the incidence of diabetes among sub-groups of the population defined by the presence of one or more simple risk factors, and to investigate population stratification as a means of identifying groups at high risk of diabetes.
  
  
  METHODS
  Data from EPIC-Norfolk (1993-1998), a population-based cohort study of 24,714 men and women aged 40-78 years without self-reported diabetes at baseline, were analyzed. During 12 years of follow-up, 608 new cases of diabetes were recorded.
  
  
  RESULTS
  Age (RR 1.03; 95% CI 1.02, 1.04), parental history of diabetes (RR 2.15; 95% CI 1.80, 2.57), BMI (RR 1.76; 95% CI 1.53, 2.02) and physical activity (RR 0.72-0.77 (reference sedentary)) were independently related to risk of diabetes. Sedentary, obese individuals aged over 55 years, with a parental history of diabetes were 18 times more likely to develop diabetes than those in the lowest risk group.
  
  
  CONCLUSIONS
  Sedentary, obese men and women over 55 years with a parental history of diabetes form a readily identifiable group, which could be targeted for screening and primary prevention. Groups such as that defined by physical inactivity alone would be more suitable for population level approaches.
authors.affiliation: MRC Epidemiology Unit, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK.
authors.forename: Anne-Helen
authors.initials: AH
authors.lastname: Harding
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000209:etiology*; D004739:England / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology