Glycosuric tests should not be employed in population screenings for NIDDM

Area of Science:

• Endocrinology
• Public Health
• Diagnostic Testing

Background:

• Diabetes mellitus (DM) is a significant public health concern.
• Early detection of DM is crucial for effective management and prevention of complications.
• Glycosuria testing has been considered as a potential screening method for DM.

Purpose of the Study:

• To evaluate the effectiveness of self-testing for glycosuria as a screening tool for diabetes mellitus.
• To determine the sensitivity, specificity, and predictive values of glycosuria self-testing.
• To assess the feasibility and cost-effectiveness of this screening approach.

Main Methods:

• A population-based screening study involving 3041 individuals aged 45-76 years.
• Participants performed self-testing of postprandial urine for glycosuria using provided dipsticks.
• Positive results prompted laboratory fasting blood glucose tests; a sample of negative results were also tested.

Main Results:

• The screening identified 15 cases of previously unrecognized diabetes mellitus.
• The sensitivity of the glycosuria test was low at 20.80%, while specificity was high at 99.14%.
• The positive predictive value was 46.88%, and the negative predictive value was 97.17%.

Conclusions:

• Self-testing for glycosuria is not a suitable screening method for diabetes mellitus due to its low sensitivity.
• Screening for DM should not rely on glycosuric tests.
• Selective screening using blood glucose tests in general practice for at-risk groups is recommended.