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Published on: July 5, 2022
Screening for type 2 diabetes. Lessons from the ADDITION-Europe study
M van den Donk1, A Sandbaek, K Borch-Johnsen
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
Summary
Type 2 diabetes screening in general practice is feasible, but attendance and diagnosis rates varied across the UK, Denmark, and Netherlands. Strategies are needed to improve participation and completion for effective diabetes detection.
Area of Science:
- Public Health
- Epidemiology
- Diabetes Research
Background:
- Type 2 diabetes mellitus (T2DM) poses a significant global health challenge.
- Early detection through screening programs is crucial for effective management and prevention of complications.
- General practice settings offer a primary point of contact for large populations, making them ideal for screening initiatives.
Purpose of the Study:
- To compare attendance rates and the yield of newly diagnosed Type 2 diabetes mellitus cases in screening programs across the UK, Denmark, and the Netherlands.
- To evaluate the feasibility and acceptability of T2DM screening in general practice settings within the ADDITION-Europe study.
Main Methods:
- Utilized distinct risk-scoring tools (Cambridge Diabetes Risk Score, Danish Diabetes Risk Score, Hoorn Symptom Risk Questionnaire) to identify high-risk individuals aged 40-69 years in general practice.
- Employed various screening protocols, including opportunistic screening, mailed questionnaires, and direct invitations for oral glucose tolerance tests (OGTT).
- Diagnosed T2DM based on World Health Organization 1999 criteria, utilizing random blood glucose, HbA1c, fasting blood glucose, and/or OGTT.
Main Results:
- Attendance rates for screening varied significantly, ranging from 20.2% for OGTT in Leicester to 95.1% for opportunistic random blood glucose screening in Denmark.
- The proportion of individuals diagnosed with newly detected T2DM among the target population ranged from 0.33% in Leicester to 1.09% in the Netherlands.
- Screening demonstrated feasibility and acceptability across participating centers, despite lower-than-expected diagnosis yields.
Conclusions:
- General practice-based screening for Type 2 diabetes mellitus is achievable, but current strategies result in relatively low detection rates.
- Optimizing screening program design is essential to enhance initial participant attendance and ensure the completion of diagnostic pathways.
- Further research into tailored strategies is warranted to improve the effectiveness of T2DM screening in primary care settings.
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