Vascular Health and Risk Management Dovepress Screening for Type 2 Diabetes in a Multiethnic Setting Using Known Risk Factors to Identify Those at High Risk: a Cross-sectional Study

Introduction: Screening enables the identification of type 2 diabetes mellitus (T2DM) during its asymptomatic stage and therefore allows early intervention which may lead to fewer complications and improve outcomes. A targeted screening program was carried out in a United Kingdom (UK) multiethnic population to identify those with abnormal glucose tolerance. Methods: A sample of individuals aged 25–75 years (40–75 white European) with at least one risk factor for T2DM were invited for screening from 17 Leicestershire (UK) general practices or through a health awareness campaign. All participants received a 75 g oral glucose tolerance test, cardiovascular risk assessment, detailed medical and family histories and anthropometric measurements. Results: In the 3,225 participants who were screened. 640 (20%) were found to have some form of abnormal glucose tolerance of whom 4% had T2DM, 3% impaired fasting glucose (IFG), 10% impaired glucose tolerance (IGT) and 3% both IFG and IGT. The odds of detecting IGT was approximately 60% greater (confounder-adjusted odds ratios [OR] 1.67 [1.22–2.29]) in the South Asian population. Conclusions: Around one in five people who had targeted screening have IGT, IFG or T2DM, with a higher prevalence in those of South Asian origin. The prevalence of undetected T2DM is lower in South Asians compared to previously published studies and maybe due to increased awareness of this group being at high risk.

[1]  D. Nathan Navigating the choices for diabetes prevention. , 2010, The New England journal of medicine.

[2]  A. Sheikh,et al.  Predicting risk of type 2 diabetes in England and Wales: prospective derivation and validation of QDScore , 2009, BMJ : British Medical Journal.

[3]  R. Holman,et al.  10-year follow-up of intensive glucose control in type 2 diabetes. , 2008, The New England journal of medicine.

[4]  Nicola J Cooper,et al.  Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis , 2008, BMJ : British Medical Journal.

[5]  K Lachowycz,et al.  Diabetes prevalence in England, 2001—estimates from an epidemiological model , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[6]  A. Vyas,et al.  A pilot randomized trial in primary care to investigate and improve knowledge, awareness and self‐management among South Asians with diabetes in Manchester , 2003, Diabetic medicine : a journal of the British Diabetic Association.

[7]  R. Bhopal,et al.  Microalbuminuria is more frequent in South Asian than in European origin populations: a comparative study in Newcastle, UK , 2003, Diabetic medicine : a journal of the British Diabetic Association.

[8]  R. Holman,et al.  Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes?: U.K. prospective diabetes study 61. , 2002, Diabetes care.

[9]  A. Hamsten,et al.  Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study , 2002, The Lancet.

[10]  K. Cruickshank,et al.  High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city: relative poverty, history, inactivity, or 21st century Europe? , 2001, Diabetes care.

[11]  S. Yusuf,et al.  The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. , 1999, Diabetes care.

[12]  K. Alberti,et al.  Comparison of the current WHO and new ADA criteria for the diagnosis of diabetes mellitus in three ethnic groups in the UK , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[13]  R. Klein,et al.  Onset of NIDDM occurs at Least 4–7 yr Before Clinical Diagnosis , 1992, Diabetes Care.

[14]  D. Simmons,et al.  Prevalence of Diabetes in Different Regional and Religious South Asian Communities in Coventry , 1992, Diabetic medicine : a journal of the British Diabetic Association.

[15]  D. Simmons,et al.  The Coventry Diabetes Study: prevalence of diabetes and impaired glucose tolerance in Europids and Asians. , 1991, The Quarterly journal of medicine.

[16]  Many South Asian people probably need pre-diabetes care , 2018 .

[17]  A. Brennan,et al.  Screening for type 2 diabetes: literature review and economic modelling. , 2007, Health technology assessment.

[18]  L. Sjöström,et al.  XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. , 2004, Diabetes care.

[19]  UK Prospective Diabetes Study (UKPDS). VIII. Study design, progress and performance. , 1991, Diabetologia.