title: Impact of a diabetes screening program on a rural Chinese population: a 3-year follow-up study.
abstract: BACKGROUND
  Screening for type 2 diabetes helps detect previously unknown diabetes and identify people with pre-diabetes, but the adverse impact of such screening on individuals labelled as pre-diabetes or classified as normal, is less known. In this study the health-related quality of life (HRQoL), depression and lifestyle changes in a rural Chinese population are assessed three years after a screening program.
  
  
  METHODS
  A total of 647 (39.1%) individuals with pre-diabetes and 1009 (60.9%) individuals with normoglycaemia from a population-based diabetes screening program in 2009 were re-examined in 2012-2013. Changes at the end of 3 years in HRQoL, depression, BMI, weight, frequency of physical activity and vegetable intake were assessed.
  
  
  RESULTS
  In men with normoglycaemia the mean (SD) 15D scores were 0.974 (0.04) at baseline and 0.973 (0.05) at follow-up; and 0.971 (0.05) and 0.966 (0.06) for men with pre-diabetes. In women the scores were 0.973 (0.05) and 0.963 (0.06) for normoglycaemia and 0.959 (0.06) and 0.954 (0.07) for pre-diabetes, respectively. Compared to baseline, the HRQoL was slightly lower at 3 years in all groups but the change was not considered to be clinically important, and was only statistically significant for women with normoglycaemia (p < 0.05). The depression score was slightly elevated in women, but not in men. No significant changes in BMI were noticed, but weight increased slightly in the normoglycemia group (p < 0.05). Screening had a significant positive impact on physical activity and vegetable intake.
  
  
  CONCLUSIONS
  This population-based diabetes screening program generated long-term positive changes toward a healthy lifestyle as measured by physical activity and vegetable intake for all the participants without adverse effects on the HRQoL and depression.
authors.affiliation: Department of Public Health, Clinicum, University of Helsinki, Mannerheimintie 172, PL41, Helsinki, 00014, Finland. yanlei.zhang@helsinki.fi.
authors.forename: Yanlei
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Qingdao Municipal Centre for Disease Control and Prevention, Qingdao, China. ningf1010@126.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Ning
authors.affiliation: Qingdao Municipal Centre for Disease Control and Prevention, Qingdao, China. qdcdcsjp@126.com.
authors.forename: Jianping
authors.initials: J
authors.lastname: Sun
authors.affiliation: Qingdao Municipal Centre for Disease Control and Prevention, Qingdao, China. zengchang.pang@gmail.com.
authors.forename: Zengchang
authors.initials: Z
authors.lastname: Pang
authors.affiliation: Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China. xiaoyong_wang@126.com.
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Wang
authors.affiliation: World Diabetes Foundation, Gentofte, Denmark. dranilkapur@gmail.com.
authors.forename: Anil
authors.initials: A
authors.lastname: Kapur
authors.affiliation: Department of Public Health, Clinicum, University of Helsinki, Mannerheimintie 172, PL41, Helsinki, 00014, Finland. harri.sintonen@helsinki.fi.
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.affiliation: Department of Public Health, Clinicum, University of Helsinki, Mannerheimintie 172, PL41, Helsinki, 00014, Finland. qing.qiao@helsinki.fi.|Observational Research Center, GMA, AstraZeneca, Mölndal, Sweden. qing.qiao@helsinki.fi.
authors.forename: Qing
authors.initials: Q
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000368:Aged; D001835:Body Weight; D002681:China / Q000453:epidemiology; D003863:Depression; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology; D011788:Quality of Life; D012424:Rural Population