Optimizing screening procedures for early detection of glycemic disorders
https://doi.org/10.14341/DM201418-14
Abstract
Aim.
To estimate the actual prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in individuals at high risk for T2DM and to develop an optimized stepwise screening procedure.
Materials and Methods.
A mobile diagnostic unit conducted outpatient screening for glycemic disorders. First stage of the survey included distribution of the FINDRISK questionnaire within the target subpopulation. At the second stage, study groups were formed based on the acquired data. Third stage involved clinical evaluation of glucose homeostasis by testing HbA1c levels and performing oral glucose tolerance test (OGTT). Individuals considered at high risk for development of T2DM were referred to specialized educational programs. A total of 2200 subjects were included in the present survey. In 1377 cases OGTT was supplemented with the testing of HbA1c. Statistical processing of the data was performed with Microsoft Excel software utility.
Results.
The interpretation of OGTT results identified 53.5% (n=1176) of study subjects as positive for glycemic disorders: 26.7% (n=587) with T2DM and 26.8% (n=589) with prediabetes, respectively. Impaired glucose tolerance was detected in 12.1% (n=266), impaired fasting glucose ? in 9.1% (n=199), and the combination of these two conditions ? in 5.6% (n=124) of examined individuals, respectively. In 235 subjects (17.1%) T2DM was diagnosed by means of HbA1c testing. 45% of examined individuals (n=620) had HbA1c<5.7%, 37.9% (n=522) showed HbA1c between 5.7% and 6.4%.
Conclusion.
A stepwise procedure allows for higher screening performance in subjects at risk for development of T2DM. Overall prevalence of T2DM, identified either by OGTT or HbA1c testing made up 31,1% of the examined sampling. Results from both methods were in agreement in 39.2% of cases.
To estimate the actual prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in individuals at high risk for T2DM and to develop an optimized stepwise screening procedure.
Materials and Methods.
A mobile diagnostic unit conducted outpatient screening for glycemic disorders. First stage of the survey included distribution of the FINDRISK questionnaire within the target subpopulation. At the second stage, study groups were formed based on the acquired data. Third stage involved clinical evaluation of glucose homeostasis by testing HbA1c levels and performing oral glucose tolerance test (OGTT). Individuals considered at high risk for development of T2DM were referred to specialized educational programs. A total of 2200 subjects were included in the present survey. In 1377 cases OGTT was supplemented with the testing of HbA1c. Statistical processing of the data was performed with Microsoft Excel software utility.
Results.
The interpretation of OGTT results identified 53.5% (n=1176) of study subjects as positive for glycemic disorders: 26.7% (n=587) with T2DM and 26.8% (n=589) with prediabetes, respectively. Impaired glucose tolerance was detected in 12.1% (n=266), impaired fasting glucose ? in 9.1% (n=199), and the combination of these two conditions ? in 5.6% (n=124) of examined individuals, respectively. In 235 subjects (17.1%) T2DM was diagnosed by means of HbA1c testing. 45% of examined individuals (n=620) had HbA1c<5.7%, 37.9% (n=522) showed HbA1c between 5.7% and 6.4%.
Conclusion.
A stepwise procedure allows for higher screening performance in subjects at risk for development of T2DM. Overall prevalence of T2DM, identified either by OGTT or HbA1c testing made up 31,1% of the examined sampling. Results from both methods were in agreement in 39.2% of cases.
About the Authors
Inna Vladimirovna Misnikova
Moscow Regional Research Clinical Institute named after M.F.Vladimerskiy
Russian Federation
MD, PhD, Professor, Leading Researcher, Therapeutic Endocrinology Department
Russian Federation
MD, PhD, Professor, Leading Researcher, Therapeutic Endocrinology Department
Alexander Vasil'evich Dreval
Moscow Regional Research Clinical Institute named after M.F.Vladimerskiy
Russian Federation
MD, PhD, Professor, Head of Therapeutic Endocrinology Department
Russian Federation
MD, PhD, Professor, Head of Therapeutic Endocrinology Department
Yulia Alexandrovna Kovaleva
Moscow Regional Research Clinical Institute named after M.F.Vladimerskiy
Russian Federation
MD, PhD, Researcher in Therapeutic Endocrinology Department
Russian Federation
MD, PhD, Researcher in Therapeutic Endocrinology Department
Valeria Alekseevna Gubkina
Moscow Regional Research Clinical Institute named after M.F.Vladimerskiy
Russian Federation
MD, PhD, Senior Researcher in Therapeutic Endocrinology Department
Russian Federation
MD, PhD, Senior Researcher in Therapeutic Endocrinology Department
Tatiana Sergeevna Lakeeva
Moscow Regional Research Clinical Institute named after M.F.Vladimerskiy
Russian Federation
MD, PhD, Phisician in Emergency medical care advisory Department
Russian Federation
MD, PhD, Phisician in Emergency medical care advisory Department
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Misnikova I.V., Dreval A.V., Kovaleva Yu.A., Gubkina V.A., Lakeeva T.S. Optimizing screening procedures for early detection of glycemic disorders. Diabetes mellitus. 2014;17(1):8-14. (In Russ.) https://doi.org/10.14341/DM201418-14
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