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Detection of impaired glucose tolerance and undiagnosed type 2 diabetes in UK South Asians : an effective screening strategy

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Hanif, M. W., Valsamakis, Georgios, Dixon, A., Boutsiadis, A., Jones, A. F., Barnett, A. H. and Kumar, Sudhesh. (2008) Detection of impaired glucose tolerance and undiagnosed type 2 diabetes in UK South Asians : an effective screening strategy. Diabetes, Obesity and Metabolism, Vol.10 (No.9). pp. 755-762. ISSN 1462-8902

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Abstract

Aim: We tested a stepwise, community-based screening strategy for glucose intolerance in South Asians using a health questionnaire in conjunction with body mass index (BMI). Anthropometric measurements (waist and hip circumference, sagittal diameter and percentage body fat) were then conducted in a hospital setting followed by an oral glucose tolerance test (OGTT) to identify subjects at the highest risk and analyse the factors predicting that risk.

Methods: A health questionnaire was administered to 435 subjects in a community setting and BMI was measured. Subjects were graded by a risk score based on the health questionnaire as high, medium and low. Subjects with high and medium risk scores and a representative sample of those with low scores had anthropometric measurements in hospital followed by an OGTT. In total, 205 (47%) of the subjects had an OGTT performed.

Results: In total, 48.7% of the subjects tested with an OGTT had evidence of glucose dysregulation: 20% had diabetes and 28.7% had impaired glucose tolerance (IGT). Logistic regression model explained 49.1% of the total variability. The significant predictors of diabetes and IGT were Blood Glucose Monitoring Strips (BMI), random blood glucose (BM), sibling with diabetes and presence of diagnosed hypertension or ischaemic disease. Most of these predictors along with other heredity diabetes factors create a composite score, with high predictability, as the receiver operating curve analysis shows.

Conclusions: We describe a simple, stepwise strategy in a community setting, based on a health questionnaire and anthropometric measurements, to explain about 50% of cases with IGT and diabetes and diagnose about 50% of cases from the population screened. We have also identified factors that predict the risk.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Warwick Medical School > Clinical Sciences Research Institute (CSRI)
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Non-insulin-dependent diabetes -- Diagnosis -- Great Britain, South Asians -- Health and hygiene -- Research -- Great Britain, Medical screening -- Great Britain, Glucose tolerance tests, Non-insulin-dependent diabetes -- Risk factors
Journal or Publication Title: Diabetes, Obesity and Metabolism
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 1462-8902
Official Date: September 2008
Volume: Vol.10
Number: No.9
Number of Pages: 8
Page Range: pp. 755-762
Identification Number: 10.1111/j.1463-1326.2007.00806.x
Status: Not Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Funder: Produits Roche S.A., Takeda Yakuhin Kōgyō Kabushiki Kaisha [Takeda Pharmaceutical Industries]
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URI: http://wrap.warwick.ac.uk/id/eprint/29516

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