|
Sign In to gain access to subscriptions and/or personal tools.
|
Screening patients with ischaemic heart disease and hypertension for undiagnosed diabetes
George Savage
The Red Practice, Crieff Medical Centre, King Street, Crieff, Perthshire, PH7 3SA, UK, gsavage{at}crieff.finix.org.uk
Peter Ewing
Helen Kirkwood
Katrina Cowie
Diabetes mellitus is an important condition with a significant morbidity and mortality. Up to 50% of people with diabetes may be as yet undiagnosed. Widespread population screening so far has had a low uptake and yield. This study is a cross-sectional survey screening for undiagnosed diabetes amongst patients with ischaemic heart disease (IHD) or hypertension, in a semi-rural practice in Scotland. The results produced a screening uptake of 83.7% and a yield of 3.48% for patients with IHD, and an uptake of 79.65% and a yield of 3% for hypertensive patients. To identify one new case of diabetes we had to screen 24 patients with IHD and 33 with hypertension. This was feasible within an organised review system for patients with these conditions with no additional resource implications. The study is limited by the lack of multi-ethnic mix, rural setting, relative affluence, and the existing organised chronic disease management plans in this practice. This may underestimate the yield if screening were to be extended to both groups nationally. More work is needed to see if such screening for diabetes is feasible and worthwhile on a national basis.
Key Words: screening diabetes mellitus ischaemic heart disease hypertension.
References
- Fuller JH, Shipley MJ, Rose G. et al. Coronary artery disease risk and impaired glucose tolerance. The Whitehall Study. Lancet 1980;1:1373-6.[Web of Science][Medline]
[Order article via Infotrieve]
- Rosengreen A., Welin L., Tsipogianni A., Wilhelmson L. Impact of cardiovascular risk factors on coronary artery disease and mortality amongst middle aged diabetic men: a general population study. BMJ 1989; 299:1127-31.[Abstract/Free Full Text]
- Kanel WB Potency of risk factors as the basis of antihypertensive therapy. Eur Heart J 1992;(suppl G):34-42.
- Scottish Office Home and Health Department. Coronary heart disease in Scotland. Edinburgh: Scot Office; 1995.
- Braumer WS, Hulley SB Effect of risk factor status on treatment criteria. Implications of hypertension trials. Hypertension 1989;13(suppl 1):51-6.[Abstract]
- Diabetes in the UK - 1996. British Diabetic Association 1995. London.
- Diabetes Control and Complications Trial (DCCT). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. N Engl J Med 1993;329:977-86.[Abstract/Free Full Text]
- Intensive blood glucose control with sulphonylurea or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes mellitus. (UKPDS 33). Lancet 1999;352:837-52.[CrossRef][Web of Science]
- The Expert Committee on the diagnosis and classification of Diabetes Mellitus. Report of the Expert Committee on the diagnosis and classification of Diabetes Mellitus. Diabetes Care 1997;20:1183-97.[Web of Science][Medline]
[Order article via Infotrieve]
- Lawrence JM, Bennett P., Young A., Robinson AM Screening for diabetes in general practice: Cross sectional population study. BMJ 2001; 323:548-51.[Abstract/Free Full Text]
- Franse LV, Di Bari M., Shorr RI et al. Type 2 Diabetes in older well-functioning people: Who is undiagnosed?: data from the Health, Aging, and Body Composition Study. Diabetes Care 2001;24(12):2065-70.[Abstract/Free Full Text]
- The Red Practice, Crieff Health Centre: Annual Report 2000.
- Bhopal R., Unwin N., White M. et al. Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study. BMJ 1999;319:215-20.[Abstract/Free Full Text]
The British Journal of Diabetes & Vascular Disease, Vol. 2, No. 3,
224-227 (2002)
DOI: 10.1177/14746514020020031501

CiteULike Complore Connotea Del.icio.us Digg Reddit Technorati Twitter What's this?
This article has been cited by other articles:

|
 |

|
 |
 
G. Savage, P. Ewing, H. Kirkwood, and S. Carter
Are undiagnosed IGT/IFG and type 2 diabetes common in heart disease and hypertension?
The British Journal of Diabetes & Vascular Disease,
November 1, 2003;
3(6):
414 - 416.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
P. H Evans, M. Luthra, R. Powell, K. G Sweeney, and D. P. Gray
Diagnosis of type 2 diabetes in primary care
The British Journal of Diabetes & Vascular Disease,
September 1, 2003;
3(5):
342 - 344.
[Abstract]
[PDF]
|
 |
|
|
|