Screening for type 2 diabetes and pre-diabetes in general practice: a descriptive study of Maltese practices.
OBJECTIVE
The aim of this research study was to ascertain the awareness of Maltese family doctors to the prevalence and significance of impaired glucose regulation and early diagnosis of type 2 diabetes and whether practices were influenced by employment status, post-graduate training in diabetes or years since graduation.


METHODS
A specially constructed questionnaire was distributed by mail to all the 298 family doctors listed as Specialists in Family Medicine in the Maltese Medical Council register. Participants had to be practising family medicine in Malta. Results were analysed using SPSS 20.0 aiming for a significance criterion of 0.05 and a power of 80%.


RESULTS
Valid replies were received from 154 GPs (51.7%). 93.2% claimed to offer their patients some form of screening. Screening levels reached up to 95.9% in the presence of specific risk factors (e.g., high previous HbA1c levels) but fell to between 46.2% and 58.7% in patients over 50, the physically inactive and those who suffer from polycystic ovarian syndrome. Screening using capillary glucose is widespread (70.8%) as opposed to the oral glucose tolerance test (23.4%). Results also show a high use of urinalysis in screening (53.2%) and a paradoxical lack of use of HbA1c in screening by young doctors and by those with recent extra training in diabetes.


CONCLUSIONS
The need for a structured screening programme in Malta and its viability need to be evaluated by further studies. Educational support to GPs together with logistic support for GPs needs to be improved.
Malta College of Family Doctors, Malta. Electronic address: marcogrech@yahoo.co.uk.
Marco
M
Grech
Institute of Health Research, University of Ulster, Derry/Londonderry, Northern Ireland, United Kingdom.
David
D
Chaney
D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001786:Blood Glucose / Q000032:analysis; D002983:Clinical Competence; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine; D042241:Early Diagnosis; D004503:Education, Medical, Graduate; D004651:Employment; D005194:Family Practice; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008319:Malta / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010821:Physicians, Family / Q000193:education / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine; D011237:Predictive Value of Tests; D015995:Prevalence; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016482:Urinalysis
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Early diagnosis; General practice; Malta; Primary care; Screening; Type 2 diabetes mellitus