title: Comparison of different stepwise screening strategies for type 2 diabetes: Finding from Danish general practice, Addition-DK.
abstract: OBJECTIVE
  To examine attendance, number of people with T2DM and costs of three different stepwise screening strategies for T2DM in general practice (GP).
  
  
  METHODS
  Diabetes risk questionnaires were mailed to individuals aged 40-69 years from 45 general practices in 2001-2002 and individuals at high risk for T2DM, were asked to contact their GP to arrange a screening test. In 2005-2006, 26 general practices were randomised into two different opportunistic screening programmes (OP-direct and OP-subsequent) and risk questionnaires were distributed to individuals aged 40-69 years during GP consultations. In the OP-direct approach, high-risk individuals were offered to start the screening during the actual consultation while high-risk individuals in the OP-subsequent approach, were invited to a screening test at a later date. We report attendance, number of people with T2DM and costs of each screening approach.
  
  
  RESULTS
  The mail-distributed approach identified 0.8% of the target population with T2DM, the OP-direct approach and the OP-subsequent approach, 0.9% and 0.5% respectively. Cost per person with T2DM was in the mail-distributed approach: € 1058, OP-direct approach: € 707 and the OP-subsequent approach: € 727.
  
  
  CONCLUSIONS
  This study indicates that opportunistic screening identifies the same level of unknown diabetes as a mail-distributed approach but with lower costs.
authors.affiliation: Department of General Health, Aarhus University, Denmark. emdl@alm.au.dk
authors.forename: Else-Marie
authors.initials: EM
authors.lastname: Dalsgaard
authors.forename: Jesper O
authors.initials: JO
authors.lastname: Christensen
authors.forename: Mette Vinter
authors.initials: MV
authors.lastname: Skriver
authors.forename: Knut
authors.initials: K
authors.lastname: Borch-Johnsen
authors.forename: Torsten
authors.initials: T
authors.lastname: Lauritzen
authors.forename: Annelli
authors.initials: A
authors.lastname: Sandbaek
mesh_terms: D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D016009:Chi-Square Distribution; D017046:Cost Savings; D003718:Denmark; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000191:economics; D005260:Female; D058006:General Practice / Q000191:economics; D005951:Glucose Tolerance Test / Q000191:economics; D006442:Glycated Hemoglobin / Q000378:metabolism; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012017:Referral and Consultation / Q000191:economics; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires / Q000191:economics
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human