Institute of Social and Preventive Medicine (IUMSP), University of Lausanne and Centre Universitaire Hospitalier Vaudois (CHUV), Lausanne, Switzerland;
Diabetes Metab Syndr Obes. 2011;4:213-23. doi: 10.2147/DMSO.S20649. Epub 2011 Jun 16.
Community-based diabetes screening programs can help sensitize the population and identify new cases. However, the impact of such programs is rarely assessed in high-income countries, where concurrent health information and screening opportunities are common place.
A 2-week screening and awareness campaign was organized as part of a new diabetes program in the canton of Vaud (population of 697,000) in Switzerland. Screening was performed without appointment in 190 out of 244 pharmacies in the canton at the subsidized cost of 10 Swiss Francs per participant. Screening included questions on risk behaviors, measurement of body mass index, blood pressure, blood cholesterol, random blood glucose (RBG), and A1c if RBG was ≥7.0 mmol/L. A mass media campaign promoting physical activity and a healthy diet was channeled through several media, eg, 165 spots on radio, billboards in 250 public places, flyers in 360 public transport vehicles, and a dozen articles in several newspapers. A telephone survey in a representative sample of the population of the canton was performed after the campaign to evaluate the program.
A total of 4222 participants (0.76% of all persons aged ≥18 years) underwent the screening program (median age: 53 years, 63% females). Among participants not treated for diabetes, 3.7% had RBG ≥ 7.8 mmol/L and 1.8% had both RBG ≥ 7.0 mmol/L and A1c ≥ 6.5. Untreated blood pressure ≥140/90 mmHg and/or untreated cholesterol ≥5.2 mmol/L were found in 50.5% of participants. One or several treated or untreated modifiable risk factors were found in 78% of participants. The telephone survey showed that 53% of all adults in the canton were sensitized by the campaign. Excluding fees paid by the participants, the program incurred a cost of CHF 330,600.
A community-based screening program had low efficiency for detecting new cases of diabetes, but it identified large numbers of persons with elevated other cardiovascular risk factors. Our findings suggest the convenience of A1c for mass screening of diabetes, the usefulness of extending diabetes screening to other cardiovascular risk factors, and the importance of a robust background communication campaign.
基于社区的糖尿病筛查项目有助于提高民众的意识并发现新病例。然而，在高收入国家，这种项目的效果很少被评估，因为这些国家同时提供了健康信息和筛查机会。
在瑞士沃州（人口 697000 人）的一项新糖尿病项目中，组织了为期两周的筛查和宣传活动。在该州的 244 家药店中的 190 家，无需预约即可进行筛查，每位参与者的费用为 10 瑞士法郎。筛查包括询问风险行为、测量体重指数、血压、血胆固醇、随机血糖（RBG），以及如果 RBG≥7.0mmol/L 则测量 A1c。通过多种媒体渠道开展了一项促进身体活动和健康饮食的大众媒体宣传活动，例如，广播 165 个广告位、250 个公共场所的广告牌、360 辆公共交通工具中的传单，以及几家报纸上的十几篇文章。活动结束后，对该州的代表性人群进行了电话调查，以评估该项目。
共有 4222 名参与者（所有≥18 岁人群的 0.76%）参加了筛查计划（中位数年龄：53 岁，女性占 63%）。在未经糖尿病治疗的参与者中，3.7%的 RBG≥7.8mmol/L，1.8%的 RBG≥7.0mmol/L 且 A1c≥6.5。未经治疗的血压≥140/90mmHg 和/或未经治疗的胆固醇≥5.2mmol/L 的患者占 50.5%。78%的参与者存在一种或多种经治疗或未经治疗的可改变的危险因素。电话调查显示，该州 53%的成年人对宣传活动有了敏感性。不包括参与者支付的费用，该项目的费用为 330600 瑞士法郎。
基于社区的筛查项目对发现新的糖尿病病例效率较低，但它发现了大量其他心血管危险因素升高的人群。我们的研究结果表明，A1c 可用于大规模筛查糖尿病，将糖尿病筛查扩展到其他心血管危险因素很有用，强大的背景宣传活动很重要。
