Screening for Diabetes Type 2 in Primary Health Care
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Abstract
BACKGROUND: The incidence of type 2 diabetes is constantly increasing. For its early detection it is necessary to find best intervention that will recognize this disease in its the early stage. The family doctor has an initial contact with the general population and has a key role in the prevention of chronic diseases.
AIM: The objective of this paper is to analyze and display the findings in available published papers related to screening for type 2 diabetes in primary care settings.
MATERIAL AND METHODS: Search results linked to the early detection of type 2 diabetes with following keywords: screening, diabetes type 2, primary health care; in PubMed, PubMed Central and Cochrane database.
RESULTS: The available literature suggests that screening may be an effective method for early detection of type 2 diabetes in primary care settings. Good results have been achieved when it is performed in structured and stratified group of patients with prior defined risk. The American Diabetes Association recommends family physicians opportunistic screening in the early detection and prevention of diabetes. Measuring blood glucose, HbA1c or OGTT as an approach can be used in the screening. Measuring blood glucose is most suitable approach in primary care settings because it is feasible, acceptable to patients, cheap and quick process. When tested positive it is important to retest the patient to confirm the diagnosis.
CONCLUSIONS: Screening for type 2 diabetes in primary care is feasible. The measurement of fasting blood glucose is the best choice for the family doctor. Effectiveness of screening varies depending on the implemented strategy. Additional research is needed in order to define best practices for determining risk groups.Downloads
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References
Chung S, Azar KMJ, Baek M, Lauderdale DS, Palaniappan LP. Reconsidering the age thresholds for type II diabetes screening in the U.S. Am J Prev Med. 2014;47:375–81.
http://dx.doi.org/10.1016/j.amepre.2014.05.012 DOI: https://doi.org/10.1016/j.amepre.2014.05.012
PMid:25131213 PMCid:PMC4171212
Klein Woolthuis EP, de Grauw WJ, van Gerwen WH, van den Hoogen HJ, van de Lisdonk EH, Metsemakers JF, van Weel C. Yield of opportunistic targeted screening for type 2 diabetes in primary care: the diabscreen study. Ann Fam Med. 2009;7(5):422-30.
http://dx.doi.org/10.1370/afm.997 DOI: https://doi.org/10.1370/afm.997
PMid:19752470 PMCid:PMC2746521
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53.
http://dx.doi.org/10.2337/diacare.27.5.1047 DOI: https://doi.org/10.2337/diacare.27.5.1047
PMid:15111519
Qvigstad E. [Prevention of type 2 diabetes--an overview]. Tidsskr Nor Laegeforen. 2004;124(23):3047-50.
PMid:15586184
Wilson, J. M. G., Jungner, G. & Organization, W. H. Principles and practice of screening for disease / J. M. G. Wilson, G. Jungner. (1968). At 6 Клиничка медицина http://www.who.int/iris/handle/10665/3765 0
WHO | Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia. At <http://www.who.int/diabetes/publications/diagnosis_diabetes2006/en/>
American Diabetes Association. Standards of medical care in diabetes--2010. Diabetes Care. 2013;33(Suppl 1):S11–61. DOI: https://doi.org/10.2337/dc10-S011
van den Donk M, et al. Screening for type 2 diabetes. Lessons from the ADDITIONEurope study. Diabet Med. 2011;28:1416–24.
http://dx.doi.org/10.1111/j.1464-5491.2011.03365.x DOI: https://doi.org/10.1111/j.1464-5491.2011.03365.x
PMid:21679235
Rifas-Shiman SL, Forman JP, Lane K, Caspard H, Gillman MW. Diabetes and lipid screening among patients in primary care: a cohort study. BMC Health Serv Res. 2008;8:25.
http://dx.doi.org/10.1186/1472-6963-8-25 DOI: https://doi.org/10.1186/1472-6963-8-25
PMid:18234107 PMCid:PMC2266727
Fox CS. Cardiovascular disease risk factors, type 2 diabetes mellitus, and the Framingham Heart Study. Trends Cardiovasc Med. 2010;20:90–5.
http://dx.doi.org/10.1016/j.tcm.2010.08.001 DOI: https://doi.org/10.1016/j.tcm.2010.08.001
PMid:21130952 PMCid:PMC3033760
Effect of intensive therapy on residual betacell function in patients with type 1 diabetes in the diabetes control and complications trial. A randomized, controlled trial. The Diabetes Control and Complications Trial Research Group. Ann Intern Med. 1998;128:517–23.
http://dx.doi.org/10.7326/0003-4819-128-7-199804010-00001 DOI: https://doi.org/10.7326/0003-4819-128-7-199804010-00001
PMid:9518395
Implications of the United Kingdom Prospective Diabetes Study. Diabetes Care. 2002;25:S28–S32.
http://dx.doi.org/10.2337/diacare.25.2007.S28 DOI: https://doi.org/10.2337/diacare.25.2007.S28
Simmons RK, et al. Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a clusterrandomised controlled trial. Lancet (London, England). 2012;380:1741–8.
http://dx.doi.org/10.1016/S0140-6736(12)61422-6 DOI: https://doi.org/10.1016/S0140-6736(12)61422-6
van Esch SCM, Heideman WH, Cleijne W, Cornel MC, Snoek FJ. Health care providers' perspective on using family history in the prevention of type 2 diabetes: a qualitative study including different disciplines. BMC Fam Pract. 2013;14:31.
http://dx.doi.org/10.1186/1471-2296-14-31 DOI: https://doi.org/10.1186/1471-2296-14-31
PMid:23497208 PMCid:PMC3599529
Klijs B, et al. Screening for type 2 diabetes in a high-risk population: study design and feasibility of a population-based randomized controlled trial. BMC Public Health. 2012;12:71.
http://dx.doi.org/10.1186/1471-2458-12-671 DOI: https://doi.org/10.1186/1471-2458-12-671
PMid:22900932 PMCid:PMC3497580
Hoerger TJ. Screening for Type 2 Diabetes Mellitus: A Cost-Effectiveness Analysis. Ann. Intern Med. 2004;140:689.
http://dx.doi.org/10.7326/0003-4819-140-9-200405040-00008 DOI: https://doi.org/10.7326/0003-4819-140-9-200405040-00008
PMid:15126252
Salopuro TM, et al. Population-level effects of the national diabetes prevention programme (FIN-D2D) on the body weight, the waist circumference, and the prevalence of obesity. BMC Public Health. 2011;11:350.
http://dx.doi.org/10.1186/1471-2458-11-350 DOI: https://doi.org/10.1186/1471-2458-11-350
PMid:21595955 PMCid:PMC3118241
Wilson SE, Rosella LC, Lipscombe LL, Manuel DG. The effectiveness and efficiency of diabetes screening in Ontario, Canada: a population-based cohort study. BMC Public Health. 2010;10:506.
http://dx.doi.org/10.1186/1471-2458-10-506 DOI: https://doi.org/10.1186/1471-2458-10-506
PMid:20727141 PMCid:PMC2936425