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The waiting game

GP diabetes screening of south Asian patients backed

Screening south Asian patients for diabetes in general practice should be used as an alternative to a national screening programme, researchers conclude.

Their study suggests targeted screening of at-risk populations may be a simpler and more effective strategy.

Researchers used a six-point health questionnaire to screen 435 south Asian patients – and found nearly half of them had type 2 diabetes or evidence of glucose dysregulation.

Professor Sudesh Kumar, a co-author of the study, said targeted screening for diabetes would avoid the massive logistical problems that a national programme would present.

‘What we have shown is that if you apply a really simple questionnaire you can screen out the people you don't need to screen, and identify those who may need treatment.'

Professor Kumar, professor of medicine at the University of Warwick, told Pulse the research would be submitted to the National Screening Committee and may feed into the NICE guidance on type 2 diabetes. ‘This is one way of screening in a targeted, yet systematic way. There are a number of groups where we could look at a similar strategy, including people over 70, or women with a history of gestational diabetes. These are patients who need early and aggressive treatment to get the same outcomes as the rest of the population.'

The questionnaire assessed a patient's risk factors, including age, family history of diabetes, heart disease or hypertension and previous gestational diabetes. Patients also had height, weight and BMI measured.

Those assessed as at moderate to high risk were sent to hospital for an oral glucose tolerance test - 49% had evidence of glucose dysregula-tion, 20% diabetes and 29% impaired glucose tolerance.

Dr Rubin Minhas, a GP in Gillingham, Kent, and chair of the South Asian Health Foundation, said blanket screening can be attractive to academics but onerous for clinicians.

He added: ‘This simple targeted approach has as high pick-up rate and is attractive in terms of both GP workload and effectiveness. It's a useful template for any diabetes screening policy that may be under consideration by the Department of Health.'

The team's analysis was published online in the journal Diabetes, Obesity and Metabolism.

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