Strategies to identify adults at high risk for type 2 diabetes
Strategies to identify adults at high risk for type 2 diabetes
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DOI：
10.2337/diacare.28.1.138
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发表时间：
2005-01-01
期刊：
影响因子：
16.2
通讯作者：
Metzger, BE
中科院分区：
文献类型：
--
作者：
Edelstein, SL;Brancati, FL;Metzger, BE
目的-糖尿病预防计划（DPP）是一项大型、多中心、随机临床试验，旨在测试预防或延迟2型糖尿病的干预措施。一个主要的挑战是确定符合条件的高风险成人定义为有糖耐量受损（IGT）（2小时血糖7.40-199 mg/dl）和空腹血糖（EFG）升高（95- 1.25mg/dl）。研究设计和方法-我们分析了筛查产量如何受到已确定的风险因素如年龄、性别、种族、BMI、和糖尿病家族史，以及通过预选毛细血管血糖水平升高的个体将提高多少产量。在158，177名接触过的成年人中，79，190人可能符合条件（无糖尿病史，年龄25岁及以上，BMI大于或等于24 kg/m2）。我们专注于30，383名参与者谁完成了口服葡萄糖耐量试验（OGTT）。结果-基于OGTT，27%有IGT与EFG，符合糖尿病高危DPP资格标准，和13%先前未诊断的糖尿病的基础上OGTT。在大多数种族群体中，年龄较大和BMI较高增加了高风险个体和新发现糖尿病患者的产量（白人，非洲裔美国人，西班牙裔美国人和美洲印第安人年龄在亚裔美国人中，年龄而不是BMI预测高风险和糖尿病。in.和BMI，初步空腹毛细血管葡萄糖预测筛选率在所有种族群体中，一个倒U型模式定义DPP资格单独（IGT-EFG）和陡峭的曲线模式定义IGT-EFG或新发现的糖尿病。空腹毛细血管葡萄糖没有减弱其他参与者的特征预测IGT-EFG或IGT-EFG和新发现的diabetes.CONCLUSIONS组合的影响-DPP筛选方法确定成人或高风险的2型糖尿病在不同种族群体，并提供指导打鼾有效使用OGTT。空腹毛细血管葡萄糖是一个有用的辅助筛查计划结合数据的年龄和肥胖。
OBJECTIVE- The Diabetes Prevention Program (DPP) was a large, multicenter, randomized clinical trial testing interventions to prevent or delay type 2 diabetes. A major challenge was to identify eligible high-risk adults defined by DPP as having both impaired glucose tolerance (IGT) (2-h glucose 7.40-199 mg/dl) and elevated fasting plasma glucose (EFG) (95-1.25 mg/dl).RESEARCH DESIGN AND METHODS - We analyzed how screening yields would be affected by the presence of established risk factors such as age, sex, ethnicity, BMI, and family history of diabetes, and how much yields would be enhanced by preselecting individuals with elevated capillary blood glucose levels. Of 158,177 contacted adults, 79,190 were potentially eligible (no history of diabetes, age 25 years and older, BMI greater than or equal to 24 kg/m(2)). We focus on the 30,383 participants who completed an oral glucose tolerance test (OGTT).RESULTS- Based on OGTT, 27% had IGT with EFG, meeting DPP-eligibility criteria for being at high risk of diabetes, and 13% had previously undiagnosed diabetes based on OGTT. Older age and higher BMI increased yield of high-risk individuals and those with newly discovered diabetes in most ethnic groups (whites, African Americans, Hispanics, and American Indians age In Asian Americans, age but not BMI predicted high risk and diabetes. in. and BMI, the preliminary fasting capillary glucose predicted screening yield in all ethnic groups, with an inverted-U pattern defining DPP eligibility alone (IGT-EFG) and a steep curvilinear pattern defining either IGT-EFG or newly discovered diabetes. Fasting capillary glucose did not attenuate the affects of other participant characteristics in predicting IGT-EFG Or the combination of IGT-EFG and newly discovered diabetes.CONCLUSIONS- The DPP screening approach identified adults with or at high risk for type 2 diabetes across various ethnic groups and provided guidance to snore efficient use of OGTTs. Fasting capillary glucose is a useful adjunct in screening programs combined with data on age and adiposity.