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Screening for diabetes in an African-American community: the Project DIRECT experience
Deborah S Porterfield1, Rebecca Din, Angela Burroughs
1NC Department of Health and Human Services, Project DIRECT, Raleigh, NC 27599, USA. deborah.porterfield@ncmail.net
Journal of the National Medical Association
|November 16, 2004
Summary
Community screening for diabetes mellitus in African Americans found common risk factors but few new cases. Intensive follow-up is needed but challenging, suggesting opportunistic screening is more effective.
Area of Science:
- Public Health
- Epidemiology
- Diabetes Mellitus Research
Background:
- Project DIRECT targeted diabetes mellitus prevention and control in African Americans in southeast Raleigh, NC.
- Community-based screening programs aim to identify individuals at risk for or with undiagnosed chronic diseases.
- African Americans face a disproportionately higher risk for diabetes mellitus.
Purpose of the Study:
- To evaluate the outcomes of a community-based diabetes mellitus screening program.
- To assess the prevalence of diabetes risk factors and diagnosed diabetes within the target population.
- To determine the effectiveness of follow-up protocols for positive screening results.
Main Methods:
- Conducted 183 community-based screening events between December 1996 and June 1999.
- Utilized capillary glucose concentration for initial diabetes screening.
- Referred participants with positive screens for confirmatory testing and physician follow-up.
Main Results:
- High prevalence of diabetes risk factors: 88.2% ethnic minority, 45.6% obesity, 41.7% family history.
- 197 individuals had elevated screening results.
- The prevalence of diagnosed diabetes mellitus among those with follow-up testing was 1.7%.
Conclusions:
- Community screening identified prevalent diabetes risk factors but few new diabetes cases in high-risk African Americans.
- Achieving intensive follow-up for all individuals with high screening values proved difficult.
- Results support opportunistic screening in clinical settings over broad community-based screening for diabetes mellitus due to resource effectiveness.