title: Screening for diabetes using an oral glucose tolerance test within a western multi-ethnic population identifies modifiable cardiovascular risk: the ADDITION-Leicester study.
abstract: OBJECTIVE
  The aim of this study was to determine the frequency of undiagnosed glucose abnormalities and the burden of cardiovascular disease (CVD) risk among south Asians and white Europeans attending a systematic screening programme for type 2 diabetes (ADDITION-Leicester) and to estimate the achievable risk reduction in individuals identified with glucose disorders.
  
  
  METHODS
  Random samples of individuals (n = 66,320) from 20 general practices were invited for a 75 g OGTT and CVD risk assessment. Ten-year CVD risk among screen-detected people with diabetes or impaired glucose regulation (IGR) (impaired fasting glycaemia and/or impaired glucose tolerance [IGT]) was computed using the Framingham-based ETHRISK engine and achievable risk reduction was predicted using relative reductions for treatments extracted from published trials.
  
  
  RESULTS
  A total of 6,041 participants (48% male, 22% south Asian) aged 40-75 years inclusive were included. Undiagnosed glucose disorders occurred more frequently in south Asians than white Europeans; age and sex adjusted odds ratios were 1.74 (95% CI 1.42-2.13) and 2.30 (95% CI 1.68-3.16) for IGT and diabetes respectively. Prevalence of any undetected glucose disorder was 17.5% in the whole cohort. Adjusted 10-year risk was similar in screen-detected people with IGR and diabetes (18.3% vs 21.6%), and was higher in south Asians across the glucose spectrum. Absolute CVD risk reductions of up to 13% in those with screen-detected type 2 diabetes and 6% in IGR are achievable using existing cardioprotective therapies.
  
  
  CONCLUSIONS
  Population screening with an OGTT identifies a significant burden of modifiable CVD risk, especially within south Asian groups. Strategies enticing this population to consider screening programmes are urgently needed as significant risk reduction is possible once a glucose abnormality is identified.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00318032.
  
  
  BACKGROUND
  The project is funded for support and treatment costs by NHS Department of Health Support for Science and project grants.
authors.affiliation: Vascular Research Group, Department of Cardiovascular Sciences, Victoria Building, Leicester Royal Infirmary, London Road, Leicester LE1 5WW, UK. david.webb@uhl-tr.nhs.uk
authors.forename: D R
authors.initials: DR
authors.lastname: Webb
authors.forename: L J
authors.initials: LJ
authors.lastname: Gray
authors.forename: K
authors.initials: K
authors.lastname: Khunti
authors.forename: B
authors.initials: B
authors.lastname: Srinivasan
authors.forename: N
authors.initials: N
authors.lastname: Taub
authors.forename: S
authors.initials: S
authors.lastname: Campbell
authors.forename: J
authors.initials: J
authors.lastname: Barnett
authors.forename: A
authors.initials: A
authors.lastname: Farooqi
authors.forename: J B
authors.initials: JB
authors.lastname: Echouffo-Tcheugui
authors.forename: S J
authors.initials: SJ
authors.lastname: Griffin
authors.forename: N J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D005060:Europe / Q000208:ethnology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001786:Blood Glucose