Population impact of strategies for identifying groups at high risk of type 2 diabetes.
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.
Harding
Anne-Helen
AH
MRC Epidemiology Unit, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK.
Griffin
Simon J
SJ
Wareham
Nicholas J
NJ
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