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GP diabetes screening a step closer

Screening patients for diabetes in primary care is feasible

and effective, according to new research from the national screening pilots.

Dr Elizabeth Goyder, senior clinical lecturer in public health at the University of Sheffield who carried out the evaluation, said: 'The overall message was positive ­ we

have shown it is feasible even

in areas with high ethnic

populations and areas with high deprivation.'

A second research team found a simple two-step process could identify the majority

of undiagnosed diabetes, and that screening on the basis of risk factors rather than age

may be more efficacious and cost-effective.

Offering a fasting plasma glucose test to all patients with hypertension or a BMI over 30kg/m2, and then an oral glucose tolerance test if the results were 6.0 mmol/l, or greater had a sensitivity of more than 70

per cent.

In south Asian patients the protocol was modified to offer screening to all patients with a BMI over 24.5 kg/m2.

Study author Dr Azhar Far-ooqi, GP in Leicester and a

clinical lead for diabetes, said: 'If you're going to screen you need a method that's going

to identify those at high risk. It's difficult to test the whole population.

'This is a pragmatic way forward that most practices would probably manage.'

But Sir Muir Gray, director of the National Screening Committee, said any screening would probably have to be based on age for practical

reasons.

He told Pulse that the results would feed into the proposed cardiovascular screening programme, but said: 'Many GP records don't have BMI. At the moment age is the simplest thing to do.'

The committee aims to finalise plans for a national

cardiovascular and diabetes screening programme, based in general practice, this year.

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