A type 2 diabetes screening program by general practioners in a Belgian at risk population

Area of Science:

• Endocrinology
• Public Health
• Epidemiology

Background:

• Type 2 diabetes and impaired glucose tolerance (IGT) represent significant global health challenges.
• Early detection and management are critical for preventing diabetes-related complications.

Purpose of the Study:

• To establish a national screening program in Belgium to determine the prevalence of undiagnosed IGT and type 2 diabetes.
• To assess these conditions in a general population with identified risk factors.

Main Methods:

• A cohort of 10,201 individuals was screened by 1,466 general practitioners between 1995 and 1998.
• A three-step diagnostic protocol involving random and fasting plasma glucose tests, and an oral glucose tolerance test when necessary, was employed.
• Diagnosis adhered to World Health Organization (WHO) criteria.

Main Results:

• Impaired glucose tolerance was detected in 3% of participants, and diabetes in 11%.
• Individuals with abnormal glucose metabolism were significantly older and had higher body mass index (BMI) compared to non-diabetic subjects.
• The prevalence of undiagnosed diabetes was 14% using the American Diabetes Association (ADA) fasting plasma glucose threshold of 126 mg/dl, versus 11% using the WHO threshold of 140 mg/dl.

Conclusions:

• Undiagnosed abnormal glucose metabolism, particularly type 2 diabetes, is highly prevalent in the Belgian population at risk.
• These findings highlight the importance of targeted screening programs for early detection and intervention.