Scherbaum W A, Dicken H-D, Verheyen F, Baehring T
Deutsche Diabetes-Klinik, Deutsches Diabetes-Zentrum, Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heinrich-Universität Düsseldorf, Düsseldorf.
Dtsch Med Wochenschr. 2006 Oct 6;131(40):2208-12. doi: 10.1055/s-2006-951353.
The detection of unknown cases of diabetes mellitus is of great medical and public health interest. In the present study a stepwise screening procedure was used to examine the effectiveness of a diabetes-risk questionnaire at a population level.
58,254 insured persons (34,179 men and 24,075 women (55 years and older) enrolled in the Health Insurance "Techniker Krankenkasse" of Thuringia and the Duesseldorf area were contacted per mail to participate. 21,218 returned the questionnaire. They were contacted again and encouraged to participate in a medical check-up for early detection of diabetes.
Data of 4,314 individuals (20.3%) who participated in the medical check-up were analysed. Their fasting blood glucose was measured (FBG, n=3,888) and, if necessary, they underwent an additional oral glucose tolerance test (OGTT, n=2,048). In 192 cases (4.5%) the general practitioner (GP) diagnosed manifest diabetes mellitus. In an additional 393 patients (9.1%) an impaired glucose tolerance was found. Analysis of documented blood glucose measurements suggested a manifest diabetes mellitus in 3.5% (by OGTT) and 10.3% (by FBG), as well as an impaired glucose tolerance in 16.1% (by OGTT) and 36.6% (by FBG).
These results demonstrate good effectiveness of the screening procedure among the participants of a medical check-up programme for early detection of diabetes mellitus and its precursors. However, the effectiveness of population-based diabetes screening with only a mailing of a risk questionnaire was unsatisfactory.
糖尿病未知病例的检测具有重大的医学和公共卫生意义。在本研究中，采用了逐步筛查程序来检验糖尿病风险问卷在人群层面的有效性。
通过邮件联系了图林根州和杜塞尔多夫地区参加“技术人员健康保险”的58254名参保人员（34179名男性和24075名女性，年龄在55岁及以上），邀请他们参与。21218人返回了问卷。再次联系他们并鼓励其参加糖尿病早期检测的医学检查。
分析了4314名（20.3%）参加医学检查的个体的数据。测量了他们的空腹血糖（FBG，n = 3888），必要时，他们还接受了额外的口服葡萄糖耐量试验（OGTT，n = 2048）。在192例（4.5%）中，全科医生诊断为显性糖尿病。在另外393例患者（9.1%）中发现葡萄糖耐量受损。对记录的血糖测量分析表明，显性糖尿病的比例为3.5%（通过OGTT）和10.3%（通过FBG），葡萄糖耐量受损的比例为16.1%（通过OGTT）和36.6%（通过FBG）。
这些结果表明，在糖尿病及其前期的早期检测医学检查项目参与者中，筛查程序具有良好的有效性。然而，仅通过邮寄风险问卷进行基于人群的糖尿病筛查的有效性并不理想。
