Screening for type 2 diabetes and impaired glucose metabolism – the Australian experience

Colagiuri, Stephen, Hussain, Zafirul, Zimmet, Paul, Cameron, Adrian and Shaw, Jonathon 2004, Screening for type 2 diabetes and impaired glucose metabolism – the Australian experience, Diabetes care, vol. 27, no. 2, pp. 367-371.

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Title Screening for type 2 diabetes and impaired glucose metabolism – the Australian experience
Author(s) Colagiuri, Stephen
Hussain, Zafirul
Zimmet, Paul
Cameron, AdrianORCID iD for Cameron, Adrian
Shaw, Jonathon
Journal name Diabetes care
Volume number 27
Issue number 2
Start page 367
End page 371
Publisher American Diabetes Association
Place of publication [Alexandria, Va.]
Publication date 2004-02
ISSN 0149-5992
Summary OBJECTIVE--To assess the Australian protocol for identifying undiagnosed type 2 diabetes and impaired glucose metabolism.

RESEARCH DESIGN AND METHODS--The Australian screening protocol recommends a stepped approach to detecting undiagnosed type 2 diabetes based on assessment of risk status, measurement of fasting plasma glucose (FPG) in individuals at risk, and further testing according to FPG. The performance of and variations to this protocol were assessed in a population-based sample of 10,508 Australians.

RESULTS--The protocol had a sensitivity of 79.9%, specificity of 79.9%, and a positive predictive value (PPV) of 13.7% for detecting undiagnosed type 2 diabetes and sensitivity of 51.9% and specificity of 86.7% for detecting impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). To achieve these diagnostic rates, 20.7% of the Australian adult population would require an oral glucose tolerance test (OGTT). Increasing the FPG cut point to 6.1 mmol/l (110 mg/dl) or using Hb[A.sub.1c], instead of FPG to determine the need for an OGTT in people with risk factors reduced sensitivity, increased specificity and PPV, and reduced the proportion requiring an OGTT. However, each of these protocol variations substantially reduced the detection of IGT or IFG.

CONCLUSIONS--The Australian screening protocol identified one new case of diabetes for every 32 people screened, with 4 of 10 people screened requiring FPG measurement and 1 in 5 requiring an OGTT. In addition, 1 in 11 people screened had IGT or IFG. Including Hb[A.sub.1c] measurement substantially reduced both the number requiring an OGTT and the detection of IGT or IFG.
Language eng
Field of Research 111706 Epidemiology
Socio Economic Objective 920104 Diabetes
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, American Diabetes Association
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