[Risk-stratified screening for diabetes in adults: results of the first investigation in Hungary].
Prevalence rate of diabetes mellitus, especially of type 2 diabetes, has been increasing worldwide; this is the case in Hungary as well. The early diagnosis of diabetes should be considered as one of the most important factors improving the late prognosis of the disease. Due to cost-effectiveness, screening should primarily be implemented in subjects at high risk to glucose intolerance. A risk-stratified nationwide screening procedure was performed by the Hungarian Diabetes Association in collaboration with general practitioners (GPs) in adult subjects without known diabetes. The screening procedure, which was sponsored by the 77 Elektronika Ltd (Budapest), was performed in a two steps manner. At first step, the Hungarian version of the internationally validated FINDRISC questionnaire (maximal score 26) was filled out by subjects while waiting for GP. At second step, blood glucose value in venous sample was locally measured by standard laboratory methods in subjects with a score value of > or = 12. The further diagnostic steps were carried out by WHO guidelines. As a total, 8921 subjects (59.7% women, 40.3% men) were screened between 01, April 2008 and 31, March 2009. Out of 4286 subjects with a score of > or = 12 (age 53.4 +/- 11.4 years; BMI: 29.9 +/- 4.8 kg/m2; waist circumference: 101.7 +/- 12.7 cm) 3733 (87.1%) had normal fasting blood glucose values, while 283 subjects (6.6%) had IFG, 122 (2.85%) had IGT and 19 participants (0.44%) had isolated IGT. Unknown diabetes was found in 129 subjects (3.01%). If the score value requiring laboratory confirmation was set at higher level (> or = 15 or > or = 20), the proportion of subjects with any degree of glucose intolerance increased. Among anthropometric parameters, BMI had the strongest association with the risk of glucose intolerance: 1 kg/m 2 increase in BMI value increased the risk of abnormal score category (> or = 12) by 24.7% (95% confidence interval: 23.3-26.2%). The risk-stratified screening procedure proved to be simple and effective for detecting early impairment of the carbohydrate metabolism, therefore, its wider implementation should be considered advisable.
Winkler
Gábor
G
Fovárosi Szent János Kórház és Eszak-budai Egyesített Intézményei, II. Belgyógyászat-Diabetológia, Budapest. gabor.winkler@janoskorhaz.hu
Hidvégi
Tibor
T
Vándorfi
Gyôzô
G
Jermendy
György
G
D000328:Adult; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000517:prevention & control*; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D020022:Genetic Predisposition to Disease; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D005082:Physical Exertion; D018570:Risk Assessment; D012307:Risk Factors; D014675:Vegetables; D055105:Waist Circumference
D000959:Antihypertensive Agents; D001786:Blood Glucose