Worrall G
Department of Community Medicine, Memorial University of Newfoundland, Gloverton, Canada.
J Fam Pract. 1991 Aug;33(2):155-60.
The objectives of this study were (1) to estimate the prevalence of previously unknown diabetes mellitus in an apparently healthy population aged 40 years and older, (2) to estimate the ratio of known to unknown diabetics, and (3) from this information, to estimate the true prevalence of diabetes.
A one in five random sample of healthy patients aged 40 years and older attending six rural family physician offices had their fasting plasma glucose (FPG) level tested with a reflectance glucometer. If the FPG was greater than or equal to 7.8 mmol/L (140.5 mg/dL), a second FPG test was done on a later day.
The sample of 1264 patients contained 139 known patients with diabetes. Of the remaining 1125 patients, 936 (83%) were tested. Twenty-three patients had an elevated FPG level on the first test, but only nine of them had an elevated FPG level on the second test. One new patient with diabetes was found for each 15 patients already diagnosed; thus, the prevalence of unknown diabetes in the study population was 0.7%. As a result of this survey, the estimated prevalence of diabetes in the population age 40 years and older rose from 11.0% to 11.7%, and the estimated prevalence for the entire population rose from 4.4% to 4.6%.
Routine screening for diabetes mellitus in otherwise healthy patients aged 40 years and older is not worthwhile. Such screening should be restricted to high-risk groups.
本研究的目的是：（1）估计40岁及以上看似健康人群中既往未知糖尿病的患病率；（2）估计已知糖尿病患者与未知糖尿病患者的比例；（3）根据这些信息估计糖尿病的真实患病率。
从六个乡村家庭医生诊所就诊的40岁及以上健康患者中随机抽取五分之一的样本，使用反射式血糖仪检测其空腹血糖（FPG）水平。如果FPG大于或等于7.8 mmol/L（140.5 mg/dL），则在随后一天进行第二次FPG检测。
1264名患者的样本中包含139名已知糖尿病患者。在其余1125名患者中，936名（83%）接受了检测。23名患者首次检测时FPG水平升高，但其中只有9名患者第二次检测时FPG水平升高。每15名已确诊患者中发现1名新的糖尿病患者；因此，研究人群中未知糖尿病的患病率为0.7%。由于这项调查，40岁及以上人群中糖尿病的估计患病率从11.0%升至11.7%，整个人群的估计患病率从4.4%升至4.6%。
对40岁及以上其他方面健康的患者进行糖尿病常规筛查是不值得的。这种筛查应仅限于高危人群。
