基于记录的、逐步的 2 型糖尿病筛查纳入年度心血管保健审查系统：来自英国一般实践的发现。

Record-based, stepwise screening for type 2 diabetes integrated into an annual cardiovascular care review system: Findings from a UK general practice.

机构信息

School of Clinical Medicine, University of Cambridge, UK.

出版信息

Prim Care Diabetes. 2011 Dec;5(4):265-9. doi: 10.1016/j.pcd.2011.09.001. Epub 2011 Oct 2.

DOI:10.1016/j.pcd.2011.09.001

PMID:21968319

Abstract

AIMS

Screening high-risk individuals for type 2 diabetes (T2DM) is recommended by many organisations. We report results from a pragmatic stepwise T2DM screening programme integrated into an annual review system in a UK general practice.

METHODS

Patients with hypertension, cardiovascular disease or chronic kidney disease attending an annual review were screened for dysglycaemia by random blood glucose (RBG) measurement. At the discretion of the usual doctor, individuals with an RBG≥6.1 mmol/l were invited to return for fasting blood glucose (FBG) or HbA(1C) measurement, allowing diagnosis of T2DM.

RESULTS

786 eligible patients were invited for T2DM screening as part of their annual review. 544 attended screening, of whom 120 had an RBG≥6.1 mmol/l. 40 individuals attended FBG measurement and 8 individuals attended HbA(1C) measurement, leading to 9 T2DM diagnoses. The positive predictive value of the test for T2DM was 19% and the laboratory cost was £91 per patient diagnosed with T2DM.

CONCLUSIONS

It is feasible to integrate a simple T2DM screening programme within an annual review system in a UK general practice. Different strategies may be required to increase initial attendance and ensure completion of the screening programme.

摘要

目的

许多组织建议对 2 型糖尿病（T2DM）高危个体进行筛查。我们报告了在英国普通实践中，将 2 型糖尿病逐步筛查方案整合到年度审查系统中的实用结果。

方法

患有高血压、心血管疾病或慢性肾脏病并接受年度审查的患者通过随机血糖（RBG）测量筛查糖基化。根据常规医生的判断，将 RBG≥6.1mmol/l 的个体邀请回来进行空腹血糖（FBG）或 HbA（1C）测量，以诊断 T2DM。

结果

786 名符合条件的患者被邀请参加年度审查中的 T2DM 筛查。544 名患者参加了筛查，其中 120 名患者的 RBG≥6.1mmol/l。40 名患者接受了 FBG 测量，8 名患者接受了 HbA（1C）测量，导致 9 例 T2DM 诊断。该测试对 T2DM 的阳性预测值为 19%，每位确诊 T2DM 的患者的实验室成本为 91 英镑。