Screening for type 2 diabetes is feasible, acceptable, but associated with increased short-term anxiety: a randomised controlled trial in British general practice.
BACKGROUND
To assess the feasibility and uptake of a diabetes screening programme; to examine the effects of invitation to diabetes screening on anxiety, self-rated health and illness perceptions.


METHODS
Randomised controlled trial in two general practices in Cambridgeshire. Individuals aged 40-69 without known diabetes were identified as being at high risk of having undiagnosed type 2 diabetes using patient records and a validated risk score (n = 1,280). 355 individuals were randomised in a 2 to 1 ratio into non-invited (n = 238) and invited (n = 116) groups. A stepwise screening programme confirmed the presence or absence of diabetes. Six weeks after the last contact (either test or invitation), a questionnaire was sent to all participants, including non-attenders and those who were not originally invited. Outcome measures included attendance, anxiety (short-form Spielberger State Anxiety Inventory-STAI), self-rated health and diabetes illness perceptions.


RESULTS
95 people (82% of those invited) attended for the initial capillary blood test. Six individuals were diagnosed with diabetes. Invited participants were more anxious than those not invited (37.6 vs. 34.1 STAI, p-value = 0.015), and those diagnosed with diabetes were considerably more anxious than those classified free of diabetes (46.7 vs. 37.0 STAI, p-value = 0.031). Non-attenders had a higher mean treatment control sub-scale (3.87 vs. 3.56, p-value = 0.016) and a lower mean emotional representation sub-scale (1.81 vs. 2.68, p-value = 0.001) than attenders. No differences in the other five illness perception sub-scales or self-rated health were found.


CONCLUSIONS
Screening for type 2 diabetes in primary care is feasible but may be associated with higher levels of short-term anxiety among invited compared with non-invited participants.
General Practice & Primary Care Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. paul.park@dphpc.ox.ac.uk
Paul
P
Park
Rebecca K
RK
Simmons
A Toby
AT
Prevost
Simon J
SJ
Griffin
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000523:psychology; D005194:Family Practice; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology; D010865:Pilot Projects; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom
D001786:Blood Glucose