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Targeted GP diabetes screening may uncover 300,000 new cases

By Cato Pedder

A simple targeted screening programme could help GPs identify a third of the one million undiagnosed type 2 diabetics in the UK, new research suggests.

The study found it was feasible and cost-effective to search existing GP records by age and body mass index to identify high-risk patients for fasting plasma glucose testing.

Researchers from Mid-

Devon primary care research group concluded the best strategy was to screen every patient aged over 50 whose BMI was 27 or above.

Dr Colin Greaves, study co-author and research fellow in primary care at the University of Exeter, said: 'You could identify a third of undiagnosed people using this system.'

The researchers tested the fasting plasma glucose levels of 1,287 patients from 16 practices and repeated any abnormal test to confirm diagnosis.

Some 70 previously un-identified cases of diabetes were diagnosed along with 125 cases of impaired fasting glycaemia (IFG), according to a report in this month's Family Practice.

After dividing patients into four groups with progressively increased risk, the researchers concluded that the relatively flat distribution of cases by age/BMI favoured screening anyone over 50 with a BMI of 27 or higher.

Dr Jonathan Stead, study co-author and a GP in Exeter, said: 'This begins to give us a clue as to how to find those with diabetes who are as yet undiagnosed. My view would be that it is really important we know about these people.'

Identifying patients by age and BMI was 'not difficult' using existing practice software, he added.

The screening programme could cut the incidence of diabetes by identifying patients with IFG early enough to prevent progression of the problem through exercise and diet, said Dr Stead.

Dr Simon Griffin, a GP member of a Government task-force that is due to recommend a national diabetes screening policy next year, said targeting screening by age and BMI was likely to be the most 'sensible cost-effective option'.

But Dr Griffin, lecturer in public health at the University of Cambridge, warned: 'It depends on the quality and accessibility of the data in primary care for identifying those at risk, the uptake of the offer of a screening test and the spare capacity in primary care to undertake this work.'

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