Kockázatalapú diabetesszurés felnottek körében

az elso hazai vizsgálat eredményei

Translated title of the contribution: Risk-stratifi ed screening for diabetes in adult subjects: Results of the fi rst investigation in Hungary

G. Winkler, Tibor Hidvégi, Gyozo Vándorfi, G. Jermendy

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Prevalence rate of diabetes mellitus, especially of type 2 diabetes, has been increasing worldwide; this is the case in Hungary as well. The early diagnosis of diabetes should be considered as one of the most important factors improving the late prognosis of the disease. Due to cost-effectiveness, screening should primarily be implemented in subjects at high risk to glucose intolerance. A risk-stratified nationwide screening procedure was performed by the Hungarian Diabetes Association in collaboration with general practitioners (GPs) in adult subjects without known diabetes. The screening procedure, which was sponsored by the 77 Elektronika Ltd (Budapest), was performed in a two steps manner. At first step, the Hungarian version of the internationally validated FINDRISC questionnaire (maximal score 26) was filled out by subjects while waiting for GP. At second step, blood glucose value in venous sample was locally measured by standard laboratory methods in subjects with a score value of ≥12. The further diagnostic steps were carried out by WHO guidelines. As a total, 8921 subjects (59.7% women, 40.3% men) were screened between 01, April 2008 and 31, March 2009. Out of 4286 subjects with a score of ≥12 (age 53.4±11.4 years; BMI: 29.9±4.8 kg/m 2 ; waist circumference: 101.7±12.7 cm) 3733 (87.1%) had normal fasting blood glucose values, while 283 subjects (6.6%) had IFG, 122 (2.85%) had IGT and 19 participants (0.44%) had isolated IGT. Unknown diabetes was found in 129 subjects (3.01%). If the score value requiring laboratory confirmation was set at higher level (≥ 15 or ≥20), the proportion of subjects with any degree of glucose intolerance increased. Among anthropometric parameters, BMI had the strongest association with the risk of glucose intolerance: 1 kg/m 2 increase in BMI value increased the risk of abnormal score category (≥12) by 24.7% (95% confidence interval: 23.3-26.2%). The risk-stratified screening procedure proved to be simple and effective for detecting early impairment of the carbohydrate metabolism, therefore, its wider implementation should be considered advisable.

Original languageHungarian
Pages (from-to)691-696
Number of pages6
JournalOrvosi Hetilap
Volume151
Issue number17
DOIs
Publication statusPublished - Apr 1 2010

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Hungary
Glucose Intolerance
General Practitioners
Blood Glucose
Carbohydrate Metabolism
Waist Circumference
Type 2 Diabetes Mellitus
Cost-Benefit Analysis
Early Diagnosis
Fasting
Diabetes Mellitus
Guidelines
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kockázatalapú diabetesszurés felnottek körében : az elso hazai vizsgálat eredményei. / Winkler, G.; Hidvégi, Tibor; Vándorfi, Gyozo; Jermendy, G.

In: Orvosi Hetilap, Vol. 151, No. 17, 01.04.2010, p. 691-696.

Research output: Contribution to journalArticle

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abstract = "Prevalence rate of diabetes mellitus, especially of type 2 diabetes, has been increasing worldwide; this is the case in Hungary as well. The early diagnosis of diabetes should be considered as one of the most important factors improving the late prognosis of the disease. Due to cost-effectiveness, screening should primarily be implemented in subjects at high risk to glucose intolerance. A risk-stratified nationwide screening procedure was performed by the Hungarian Diabetes Association in collaboration with general practitioners (GPs) in adult subjects without known diabetes. The screening procedure, which was sponsored by the 77 Elektronika Ltd (Budapest), was performed in a two steps manner. At first step, the Hungarian version of the internationally validated FINDRISC questionnaire (maximal score 26) was filled out by subjects while waiting for GP. At second step, blood glucose value in venous sample was locally measured by standard laboratory methods in subjects with a score value of ≥12. The further diagnostic steps were carried out by WHO guidelines. As a total, 8921 subjects (59.7{\%} women, 40.3{\%} men) were screened between 01, April 2008 and 31, March 2009. Out of 4286 subjects with a score of ≥12 (age 53.4±11.4 years; BMI: 29.9±4.8 kg/m 2 ; waist circumference: 101.7±12.7 cm) 3733 (87.1{\%}) had normal fasting blood glucose values, while 283 subjects (6.6{\%}) had IFG, 122 (2.85{\%}) had IGT and 19 participants (0.44{\%}) had isolated IGT. Unknown diabetes was found in 129 subjects (3.01{\%}). If the score value requiring laboratory confirmation was set at higher level (≥ 15 or ≥20), the proportion of subjects with any degree of glucose intolerance increased. Among anthropometric parameters, BMI had the strongest association with the risk of glucose intolerance: 1 kg/m 2 increase in BMI value increased the risk of abnormal score category (≥12) by 24.7{\%} (95{\%} confidence interval: 23.3-26.2{\%}). The risk-stratified screening procedure proved to be simple and effective for detecting early impairment of the carbohydrate metabolism, therefore, its wider implementation should be considered advisable.",
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