Davies M, Alban-Davies H, Cook C, Day J
Ipswich Diabetes Centre, Suffolk.
BMJ. 1991 Sep 21;303(6804):696-8. doi: 10.1136/bmj.303.6804.696.
To develop a simple, economically viable, and effective means of population screening for diabetes mellitus.
A postal request system for self testing for glycosuria with foil wrapped dipsticks. Preprandial and postprandial tests were compared with a single postprandial test. The subjects were instructed how to test, and a result card was supplied on which to record and return the result. All those recording a positive test result and 50 people recording a negative result were invited for an oral glucose tolerance test.
General practice in east Suffolk, list size 11534.
All subjects aged 45-70 years registered with the practice were identified by Suffolk Family Health Services Authority (n = 3057). The 73 subjects known to have diabetes from the practice's register were excluded, leaving 2984 subjects, 2363 (79.2%) of whom responded. 1167 subjects completed the single test and 1196 the two tests.
Response rate and number of patients with glycosuria. Sensitivity, specificity, and positive predictive value of a single postprandial test and preprandial and postprandial tests. Number of new cases of diabetes identified and cost of screening.
Of the patients completing the single postprandial test, 29 had a positive result, an oral glucose tolerance test showed that eight (28%) had diabetes, six (21%) impaired glucose tolerance, and 14 (48%) normal glucose tolerance. 44 of the group who tested before and after eating had a positive result; nine (20%) had diabetes, five (11%) impaired tolerance, and 26 (11%) normal tolerance. Screening cost 59p per subject and 81 pounds per case detected. Of the 17 people with previously undiagnosed diabetes, eight were asymptomatic and 11 had not visited their general practitioner in the past three months.
A postal request system for self testing for postprandial glycosuria in people aged 45-70 is a simple and effective method of population screening for diabetes mellitus.
开发一种简单、经济可行且有效的糖尿病群体筛查方法。
采用邮寄请求系统，使用铝箔包装的试纸进行尿糖自我检测。比较了餐前和餐后检测与单次餐后检测。指导受试者如何进行检测，并提供一张结果卡用于记录和返还结果。所有记录为阳性检测结果的人和50名记录为阴性结果的人被邀请进行口服葡萄糖耐量试验。
东萨福克郡的全科医疗，登记人数为11534人。
萨福克家庭健康服务管理局确定了该诊所登记的所有45至70岁的受试者（n = 3057）。排除该诊所登记册中已知患有糖尿病的73名受试者，剩下2984名受试者，其中2363人（79.2%）做出了回应。1167名受试者完成了单次检测，1196名受试者完成了两次检测。
回应率和尿糖患者数量。单次餐后检测以及餐前和餐后检测的敏感性、特异性和阳性预测值。新确诊的糖尿病病例数和筛查成本。
在完成单次餐后检测的患者中，29人结果呈阳性，口服葡萄糖耐量试验显示，8人（28%）患有糖尿病，6人（21%）葡萄糖耐量受损，14人（48%）葡萄糖耐量正常。在进行餐前和餐后检测的组中，44人结果呈阳性；9人（20%）患有糖尿病，5人（11%）耐量受损，26人（11%）耐量正常。筛查每位受试者花费59便士，每检测出一例花费81英镑。在17名先前未被诊断出糖尿病的患者中，8人无症状，11人在过去三个月内未看过全科医生。
针对45至70岁人群进行餐后尿糖自我检测的邮寄请求系统是一种简单有效的糖尿病群体筛查方法。
