Screening for type 2 diabetes in primary care using a stepwise protocol: The Diabscreen study

Klein Woolthuis, Erwin P.; de Grauw, Wim J.C.; van Gerwen, Willem H.E.M.; van den Hoogen, Henk J.M.; van de Lisdonk, Eloy H.; Metsemakers, Job F.M.; van Weel, Chris

doi:10.1016/j.pcd.2007.09.002

« Previous Next »Primary Care Diabetes
Volume 1, Issue 4 , Pages 199-202, December 2007

Screening for type 2 diabetes in primary care using a stepwise protocol: The Diabscreen study

Erwin P. Klein Woolthuis
- Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Corresponding author at: Radboud University Nijmegen Medical Centre, Department of General Practice, 117 HAG, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 361 44 11; fax: +31 24 354 18 62.
Wim J.C. de Grauw
- Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Willem H.E.M. van Gerwen
- Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Henk J.M. van den Hoogen
- Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Eloy H. van de Lisdonk
- Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Job F.M. Metsemakers
- Department of General Practice, University of Maastricht, Maastricht, The Netherlands
Chris van Weel
- Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Received 25 March 2007; received in revised form 19 September 2007; accepted 26 September 2007. published online 31 October 2007.

Abstract

Aim

To evaluate a stepwise protocol in opportunistic screening for type 2 diabetes.

Methods

From 2000 to 2001, in 11 Dutch general practices (n=49,229) we invited at-risk patients during usual care for a capillary fasting plasma glucose (cFPG1) measurement. If >6.0mmol/l, a second sample (cFPG2) was taken on another day, followed by a venous sample (vFPG) if cFPG2>6.0mmol/l and cFPG1 or 2≥7.0mmol/l.

Results

Of 3724 at-risk patients invited for a cFPG1, 3335 (90%) returned for the measurement. Ultimately, in 125 (4%) of them a vFPG was measured. In 101 out of 125 patients the vFPG was ≥7.0mmol/l, giving a positive predictive value of our protocol of 81%.

Conclusion

A stepwise screening protocol including two subsequent capillary blood glucose measurements from a portable blood glucose meter is well applicable in screening for type 2 diabetes in primary care.

Keywords: Screening, Type 2 diabetes, Fasting plasma glucose, Capillary, Portable blood glucose meter