Porterfield Deborah S, Din Rebecca, Burroughs Angela, Burrus Barri, Petteway Regina, Treiber Linda, Lamb Betty, Engelgau Michael
NC Department of Health and Human Services, Project DIRECT, Raleigh, NC 27599, USA.
J Natl Med Assoc. 2004 Oct;96(10):1325-31.
To report the results of a community-based screening program associated with Project DIRECT, a multiyear diabetes mellitus prevention and control project targeting African-American residents of southeast Raleigh, NC.
Between December 1996 and June 1999, 183 screening events took place in community settings. Screening was by capillary glucose concentration. Participants with a positive screen were referred for confirmatory testing and physician follow-up.
Risk factors for diabetes were prevalent, including ethnic minority race (88.2%), obesity (45.6%), and family history of diabetes (41.7%). In all, 197 personshad an elevated screening result; the prevalence of diabetes in the screened population that underwent follow-up testiing was 1.7%. Despite persistent tracking efforts, 28% of the persons with a high screening test received no final diagnosis
In this community-based screening program targeted to high-risk African Americans, risk factors for diabetes were common, but new cases of undiagnosed diabetes among participants were uncommon. Intensive follow-up for persons with high screening values is necessary but difficult to achieve. Our results support national recommendations against community-based screening; opportunistic screening for diabetes in clinical settings is likely a more effective use of resources.
报告一项与DIRECT项目相关的社区筛查项目的结果，DIRECT项目是一项针对北卡罗来纳州罗利市东南部非裔美国居民的多年糖尿病预防和控制项目。
1996年12月至1999年6月期间，在社区环境中开展了183次筛查活动。通过毛细血管血糖浓度进行筛查。筛查结果呈阳性的参与者被转介进行确诊测试和医生随访。
糖尿病的危险因素普遍存在，包括少数族裔（88.2%）、肥胖（45.6%）和糖尿病家族史（41.7%）。共有197人筛查结果升高；接受后续测试的筛查人群中糖尿病患病率为1.7%。尽管持续进行追踪努力，但28%的筛查结果高的人未得到最终诊断。
在这个针对高危非裔美国人的社区筛查项目中，糖尿病危险因素很常见，但参与者中未确诊的糖尿病新病例并不常见。对筛查值高的人进行强化随访是必要的，但难以实现。我们的结果支持国家反对社区筛查的建议；在临床环境中对糖尿病进行机会性筛查可能是更有效的资源利用方式。
