Trends in laboratory testing for diabetes in Ontario, Canada 1995-2005: A population-based study
Trends in laboratory testing for diabetes in Ontario, Canada 1995-2005: A population-based study
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DOI：
10.1186/1472-6963-9-41
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发表时间：
2009-02-27
影响因子：
2.8
通讯作者：
Manuel, Douglas G.
中科院分区：
文献类型：
--
作者：
Wilson, Sarah E.;Lipscombe, Lorraine L.;Manuel, Douglas G.
背景：人们担心2型糖尿病的检测率很低，许多糖尿病患者没有被诊断出来。我们试图描述的糖尿病相关的实验室检测率在安大略从1995年至2005年，在成年人中没有糖尿病，并探讨在何种程度上加拿大临床实践指南筛选being followed.Methods：描述性计数的门诊糖尿病实验室检测内进行安大略的公共资助，省的健康保险计划进行了记录。研究人群为1995年至2005年间20岁及以上的安大略居民（2005年为930万人）。安大略糖尿病数据库是一个来自行政健康记录的累积登记处，用于从主要分析中排除医生诊断为糖尿病的患者（2005年n= 839，127）。糖尿病测试包括血清血糖（SBG），血红蛋白A1 c（HbA1c），和口服葡萄糖耐量试验（OGTT）。结果：在2005年，37%的安大略成年人没有预先存在的糖尿病进行了测试与SBG测试，从1995年增加了28%。接受HbA1c检测的无糖尿病成年人的年龄调整比例从1995年的1.7%增加到2005年的6.0%。2005年，对糖尿病患者（483，746人）和非糖尿病患者（496，616人）进行了类似数量的HbA1c测试，尽管两组的测量结果存在很大差异。在1995年至2005年期间的任何一年，只有不到1%的安大略人接受了OGTT测试。近三分之二的成年人年龄在40岁及以上有一个SBG测试超过3年的时间（2002年4月1日至2005年3月31日），按照加拿大糖尿病协会的建议。结论：糖尿病测试是常见的，并在过去十年中有所增加。尽管在加拿大的糖尿病筛查建议中没有HbA1c检测，但在没有糖尿病的个体中，HbA1c检测正在迅速增加，而推荐的OGTT很少进行。
Background: There are concerns that testing for type 2 diabetes is low and many people with diabetes are not diagnosed. We sought to describe the rates of diabetes-related lab testing in Ontario from 1995-2005, among adults without diabetes, and to explore the extent to which the Canadian clinical practice guidelines for screening are being followed.Methods: Descriptive counts of outpatient diabetes laboratory tests performed within Ontario's publicly funded, provincial health insurance program were recorded. The study population was Ontario residents, 20 years and older from 1995 to 2005 (9.3 million people in 2005). The Ontario Diabetes Database, a cumulative registry derived from administrative health records, was used to exclude people who had physician-diagnosed diabetes (n=839,127 in 2005) from the primary analyses. Diabetes tests included serum blood glucose (SBG), hemoglobin A1c (HbA1c), and oral glucose tolerance tests (OGTT).Results: In 2005, 37% of Ontario adults without pre-existing diabetes were tested with an SBG test, a 28% increase from 1995. The age-adjusted proportion of adults without diabetes undergoing a HbA1c test increased from 1.7% in 1995 to 6.0% in 2005. In 2005, a similar number of HbA1c tests were performed for individuals with diabetes (483,746) and without diabetes (496,616) despite large differences in the two groups' denominators. Less than 1% of Ontarians underwent OGTT testing in any year between 1995-2005. Nearly two-thirds of adults age 40 years and over had an SBG test over a 3-year period (April 1, 2002-March 31, 2005), in accordance with the Canadian Diabetes Association recommendations.Conclusion: Diabetes testing is common and has increased over the last ten years. Despite its absence in Canada's diabetes screening recommendations, HbA1c testing among individuals without diabetes is increasing rapidly, and OGTT, which is recommended, is rarely performed.