title: Cost effectiveness of screening of all newly recruited employees for diabetes at a tertiary care hospital.
abstract: BACKGROUND
  Diabetes Mellitus is a disease which remains asymptomatic for long duration of time and usually diagnosed either when gets complicated or by routine or opportunistic screening. The practice of universal screening is not recommended, particularly in constraint resources. However, we embarked with a study to assess the yield of recommended screening for Type 2 diabetes in all the newly recruited employees at a tertiary care hospital in Karachi.
  
  
  METHODS
  All the information required for this study was collected from medical records of all newly recruited employees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over a period of 5 months (August 2004 to December 2004). Out of 360 subjects, 326, whose information was found to be complete, were included for final analysis.
  
  
  RESULTS
  Mean age of the study subjects was 25.3 +/- 4.7 years and their mean casual plasma glucose level was 99.1 +/- 16.3 mg/dl. 315 (96.6%) study subjects had casual plasma glucose level of 139 mg/dl or less. Only 10 (3.1%) study subjects had casual plasma glucose levels between 140 to 199 mg/dl. Just one employee, 41 years old, was found to have casual plasma glucose level of 213 mg/dl.
  
  
  CONCLUSIONS
  In this study, screening of all individuals for diabetes had a very low yield. Recommendation of universal screening for diabetes does not represent a good use of resources and perhaps not cost-effective. However, periodic screening of high risk individuals should be warranted.
authors.affiliation: Department of Family Medicine, The Aga Khan University, Karachi, Pakistan. niloufer.ali@aku.edu
authors.forename: Niloufer Sultan
authors.initials: NS
authors.lastname: Ali
authors.forename: Ali Khan
authors.initials: AK
authors.lastname: Khuwaja
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control; D004651:Employment; D005260:Female; D006282:Health Personnel / Q000191:economics; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D010564:Personnel, Hospital / Q000191:economics*; D010865:Pilot Projects