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
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
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.