Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala, Sweden.
Diabet Med. 2013 Feb;30(2):239-45. doi: 10.1111/dme.12009.
The aim of the present study was to test the effectiveness of opportunistic blood glucose screening in a cooperational framework between dental and primary health care.
Altogether, 1568 subjects, age 20-75 years, with no previous history of diabetes, who came for a regular dental examination, had their non-fasting blood glucose measured with a portable blood glucose meter. Subjects with a concentration of ≥ 6.7 mmol/l (121 mg dl(-1) ) were referred to their primary healthcare centre for follow-up. The outcome, a diagnosis of diabetes mellitus, was obtained from primary healthcare centre and hospital patient records, during 3 years after screening.
Of the 155 (9.9%) subjects who screened positive, 139 (89.7%) came to their primary healthcare centre within the 3-year follow-up period and nine (5.8%) were diagnosed as having diabetes mellitus according to the World Health Organization criteria. Of the 1413 subjects who screened negative, 1137 (80.5%) came to the primary healthcare centre and eight (0.6%) were found to have diabetes mellitus. Screening sensitivity was 52.9%, specificity 90.6% and positive predictive value 5.8%. The number of subjects needed to screen to find one case of diabetes was 196. Delineating the study population to those 40- to 75-year-olds with a BMI ≥ 25 kg/m(2) , and 30-to 75-year-olds with a BMI ≥ 30 kg/m(2) , the numbers needed to screen was reduced to 96.
Cooperation between dental and primary care for high blood glucose screening and follow-up appears to be a feasible method for early diagnosis of diabetes.
本研究旨在检验在牙科和初级保健协作框架下，机会性血糖筛查的效果。
共有 1568 名年龄在 20-75 岁、无糖尿病既往史的受试者，在进行常规牙科检查时，使用便携式血糖仪测量其非空腹血糖。血糖浓度≥6.7mmol/L（121mg/dl(-1)）的受试者被转介至初级保健中心进行随访。在筛查后 3 年内，通过初级保健中心和医院患者记录获得糖尿病的诊断结果。
在 155 名（9.9%）筛查阳性的受试者中，有 139 名（89.7%）在 3 年随访期间到初级保健中心就诊，根据世界卫生组织标准，有 9 名（5.8%）被诊断为糖尿病。在 1413 名筛查阴性的受试者中，有 1137 名（80.5%）到初级保健中心就诊，有 8 名（0.6%）被诊断为糖尿病。筛查的敏感性为 52.9%，特异性为 90.6%，阳性预测值为 5.8%。筛查发现 1 例糖尿病所需的受试者数量为 196。将研究人群限定为 40-75 岁 BMI≥25kg/m(2)的人群和 30-75 岁 BMI≥30kg/m(2)的人群，筛查所需的人数分别减少至 96。
牙科和初级保健之间的合作，进行高血糖筛查和随访，似乎是早期诊断糖尿病的一种可行方法。
