Holt Tim A, Stables David, Hippisley-Cox Julia, O'Hanlon Shaun, Majeed Azeem
Health Sciences Research Institute, University of Warwick, Coventry, CV4 7AL, UK.
Br J Gen Pract. 2008 Mar;58(548):192-6. doi: 10.3399/bjgp08X277302.
Around 1% of the UK population has diabetes that is either undiagnosed or unrecorded on practice disease registers.
To estimate the number of people in UK primary care databases with biochemical evidence of undiagnosed diabetes. To develop simple practice-based search techniques to support early recognition of diabetes.
Cross-sectional survey of 3 630 296 electronic records.
Four hundred and eighty UK practices contributing to the QRESEARCH database.
Electronic searches to identify people with no diabetes diagnosis in one of two categories (A and B), using the most recently recorded blood glucose measurement: random blood glucose level >or=11.1 mmol/l or fasting blood glucose level >or=7.0 mmol/l (A); either a random or a fasting blood glucose level >or=7.0 mmol/l (B). An additional outcome measure was the proportion of the population with at least one blood glucose measurement in the record.
The number (percentage) identified in category A was 3758 (0.10% of the total population); the number in category B was 32 785 (0.90%). Projected to a practice of 7000 patients, around eight patients have biochemical evidence of undiagnosed diabetes, and 68 have results suggesting the need for further follow-up. One-third of people aged over 40 years without diabetes have a blood glucose measurement in the past 2 years in their record.
People with possible undiagnosed diabetes are readily identifiable in UK primary care databases through electronic searches using blood glucose data. People with borderline levels, who may benefit from interventions to reduce their risk of progression to diabetes, can also be identified using practice-based software.
在英国，约1%的人口患有糖尿病，但未被诊断出来或未记录在诊所疾病登记簿上。
估算英国初级保健数据库中具有未诊断糖尿病生化证据的人数。开发基于诊所的简单搜索技术，以支持糖尿病的早期识别。
对3630296份电子记录进行横断面调查。
向QRESEARCH数据库提供数据的480家英国诊所。
通过电子搜索，使用最近记录的血糖测量值，在两类人群（A类和B类）中识别未被诊断为糖尿病的人：随机血糖水平≥11.1 mmol/l或空腹血糖水平≥7.0 mmol/l（A类）；随机或空腹血糖水平≥7.0 mmol/l（B类）。另一个结果指标是记录中有至少一次血糖测量值的人群比例。
A类中识别出的人数（百分比）为3758人（占总人口的0.10%）；B类中的人数为32785人（占0.90%）。推算到一个有7000名患者的诊所，约有8名患者有未诊断糖尿病的确切生化证据，68名患者的检测结果表明需要进一步随访。在40岁以上未患糖尿病的人群中，三分之一的人在过去两年的记录中有血糖测量值。
通过使用血糖数据进行电子搜索，在英国初级保健数据库中可以很容易地识别出可能患有未诊断糖尿病的人。使用基于诊所的软件，也可以识别出临界值水平的人群，他们可能会从降低糖尿病进展风险的干预措施中受益。
