News
Flash:
Tuesday
January 14, 2002
Journal
of General Internal Medicine
“Simple
Blood Test In Doctor's Office Could Detect New Cases Of
Diabetes”
A
simple blood test given in the doctor's office could identify
millions of patients with previously undetected diabetes, new
research reveals.
The
findings, published in the January issue of the Journal of
General Internal Medicine, also suggest that three easily
assessed risk factors can be used to identify the best candidates
for the test.
Diabetes
is one of the more prevalent and costly medical conditions in the
United States, affecting an estimated 16 million people, about six
percent of the population. It may go undiagnosed for years,
damaging organs throughout the body, until symptoms appear. That
makes early detection vital for the estimated five-million-plus
Americans who have diabetes and don’t know it.
Current
screening procedures for diabetes have not been proven
cost-effective, and community-wide screening sessions where these
procedures are used do not always result in medical follow-up with
individual physicians, says lead author David Edelman, M.D., of
the Durham Veterans’ Affairs Medical Center and Duke University
Medical Center.
Moreover,
these screenings rely on a blood sugar test that requires several
hours of prior fasting and cannot always be administered on the
spot.
To
evaluate the feasibility of other, potentially more cost-effective
screening techniques, Edelman and his colleagues selected a test
(HgA1c) that accurately indicates blood sugar levels over the
previous two to three months and can detect at least 75 percent of
cases of diabetes, but does not require fasting.
Next,
they administered this test to 1,253 patients during regular
visits to their physicians at a Veterans’ Administration medical
center.
The
participants, primarily men, were age 45 to 64 and had never been
diagnosed with diabetes. Finally, the investigators performed a
more definitive test for diabetes – the fasting glucose test –
on as many participants as possible who scored high on the first
test.
The
authors found that 4.5 percent of the study participants had
diabetes, which had gone undetected even though they were under
medical care.
This
figure is similar to nationwide estimates of undiagnosed diabetes
among men of this age and compares favorably with estimates that
undiagnosed diabetes affects approximately two percent of the
overall population.
According
to Edelman, “This [finding] suggests that there is opportunity
for diabetes case-finding even in populations receiving medical
treatment.”
Other
study findings indicate the new screening technique would detect
almost as many cases of undiagnosed diabetes if performed only on
patients with one or more of three risk factors: obesity,
self-reported high blood pressure and family history of the
disease. Such targeting would make the screening even more
cost-effective.
Support
for the research came from the Department of Veterans’ Affairs
Cooperative Studies and the Department of Veterans’ Affairs
Health Service Research and Development.
Source: Center
For The Advancement Of Health
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