Vozár J
Interné oddelenie specializované na liecbu diabetes mellitus NsP, Samorín, Slovenská republika.
Vnitr Lek. 2001 Mar;47(3):140-5.
The aim of study was to estimate the prevalence of newly detected type 2 diabetic patients and compare it with prevalence of registered type 2 diabetic patients in the Slovak republic. The second aim was to improve the cooperation between general practitioners and diabetologists in the detection of unrecognized diabetes.
Seventy-six general practitioners were involved in Slovak Diabetologic Detection Program. Randomly taken capillary glucose (glucometer One-Touch, Lifescan) was measured in 18,942 probands over 40 years of age with one or more risk factors for type 2 diabetes in nine regions of Slovakia during a 6-month period. When capillary glucose was over 6 mmol/l the proband was referred to one of the nine diabetologic outpatient clinics for further evaluation. The history, physical examination and fasting capillary glucose or oGTT were performed in these patients. After exclusion of previously registered diabetic patients, noncompliant patients and insufficient examinations the data were evaluated in 15,387 probands. This data were compared with the Slovak National Registry, which is based on yearly collected and evaluated data from all diabetologic outpatient clinics.
Newly detected (undiagnosed) type 2 diabetes was found in 444 (2.9%) and impaired fasting glucose and/or impaired glucose tolerance in 347 (2.3%) out of 15,387 probands. Data from Slovak National Registry show 9.5% type 2 diabetic patients over 40 years of age. In our detection program the number of undiagnosed type 2 diabetic patients over the age of 40 years was 2.9%. Therefore authors estimated the overall prevalence of type 2 diabetes in Slovakia over the age of 40 on 12.3% of general population in this age category (population ca 2.2 million people). When is compared prevalence of undiagnosed and registered type 2 diabetic patients it can be claimed that on three registered diabetic patients, there is one undiagnosed and one other with impaired fasting glucose and/or impaired glucose tolerance. The patients with undiagnosed diabetes and ones with impaired fasting glucose and/or impaired glucose tolerance had significantly higher body mass index and significantly higher occurrence of arterial hypertension and positive family history of diabetes compared to non-diabetic probands. Authors also achieved the second aim by establishing the collaboration between general practitioners and diabetologists in the selected nine regions of Slovakia. This relationship is essential for detection the undiagnosed diabetic patients by general practitioners and confirmation of diagnosis of diabetes as well as initiation of introductory education by diabetes specialists. Authors conclude that it is essential to actively screen for disturbances of glucose metabolism in population over 40 years old in general practice.
本研究的目的是估计新检测出的2型糖尿病患者的患病率，并将其与斯洛伐克共和国登记的2型糖尿病患者的患病率进行比较。第二个目的是改善全科医生和糖尿病专家在未被识别的糖尿病检测方面的合作。
76名全科医生参与了斯洛伐克糖尿病检测项目。在6个月期间，对斯洛伐克9个地区18942名40岁及以上有一个或多个2型糖尿病风险因素的受试者进行随机指尖血糖检测（采用One - Touch血糖仪，LifeScan）。当指尖血糖超过6 mmol/l时，将受试者转至9个糖尿病门诊之一进行进一步评估。对这些患者进行病史、体格检查以及空腹指尖血糖或口服葡萄糖耐量试验。在排除先前已登记的糖尿病患者、不依从患者和检查不充分的患者后，对15387名受试者的数据进行评估。将这些数据与斯洛伐克国家登记处的数据进行比较，该登记处基于每年从所有糖尿病门诊收集和评估的数据。
在15387名受试者中，新检测出（未诊断）的2型糖尿病患者有444例（2.9%），空腹血糖受损和/或糖耐量受损的患者有347例（2.3%）。斯洛伐克国家登记处的数据显示，40岁以上的2型糖尿病患者占9.5%。在我们的检测项目中，40岁以上未诊断的2型糖尿病患者数量为2.9%。因此，作者估计斯洛伐克40岁以上人群中2型糖尿病的总体患病率为该年龄组总人口的12.3%（该年龄段人口约220万）。比较未诊断和已登记的2型糖尿病患者的患病率可以发现，每3名已登记的糖尿病患者中，就有1名未诊断的患者以及1名空腹血糖受损和/或糖耐量受损的患者。与非糖尿病受试者相比，未诊断糖尿病的患者以及空腹血糖受损和/或糖耐量受损的患者的体重指数显著更高，动脉高血压的发生率显著更高，糖尿病家族史阳性的情况也显著更多。作者还通过在斯洛伐克选定的9个地区建立全科医生和糖尿病专家之间的合作实现了第二个目标。这种关系对于全科医生检测未诊断的糖尿病患者、确认糖尿病诊断以及糖尿病专家开展入门教育至关重要。作者得出结论，在全科医疗中积极筛查4
