Patients with impaired fasting glucose or impaired glucose tolerance who were screened for diabetes risk as part of an international diabetes study went on to develop type 2 diabetes at rates higher than those cited in textbooks and guidelines, according to a report published online in the journal Diabetologia.
The findings suggest that screening strategies based on incidence rates for the general population may not be useful for identifying type 2 diabetes in patients at high risk for the disease.
Of 1,160 patients (aged 40–69 years) who were screened at baseline, 70% (811) were reexamined at 1 year. Among those who were rescreened, there were 155 incident cases of diabetes, reported Dr. Signe Sætre Rasmussen of the Steno Diabetes Center, Gentofte, Denmark, and her colleagues at Aarhus (Denmark) University. The incidence of diabetes was 17.6/100 person-years in those with impaired fasting glucose and 18.8/100 person-years in those with impaired glucose tolerance.
These findings were based on data collected during the screening phase of the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen-Detected Diabetes in Primary Care (ADDITION), a screening and intervention study for type 2 diabetes in general practice. A treatment phase will follow (Diabetologia 2006 [Epub ahead of print]; DOI 10.1007/z00125–006–0530-y). Study participants were recruited based on their risk scores from a previous Danish diabetes screening study.
Dr. Rasmussen and colleagues concluded that the progression rates used by most screening programs are based on low rates listed in textbooks and guidelines. “Our study confirms that these are too low for high-risk settings, which would be the preferable strategy as general population-based screening programs are expensive, logistically difficult and of questionable benefit,” they wrote.
The study was funded by Novo Nordisk Inc., Astra-Zeneca Pharmaceuticals, Pfizer Inc., Servier Laboratories, GlaxoSmithKline, and HemoCue Inc. The authors reported no conflicts of interest.