Use of the diabetes risk score for opportunistic screening of undiagnosed diabetes and impaired glucose tolerance - The IGLOO (Impaired Glucose Tolerance and Long-Term Outcomes Observational) study
Use of the diabetes risk score for opportunistic screening of undiagnosed diabetes and impaired glucose tolerance - The IGLOO (Impaired Glucose Tolerance and Long-Term Outcomes Observational) study
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DOI：
10.2337/diacare.28.5.1187
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发表时间：
2005-05-01
期刊：
影响因子：
16.2
通讯作者：
Nicolucci, A
中科院分区：
文献类型：
--
作者：
Franciosi, M;De Berardis, G;Nicolucci, A
目的--以糖尿病风险评分（DRS）为初始工具，评估针对具有一个或多个心血管危险因素的个体的所有机会性筛查策略，用于识别患有2型糖尿病或糖耐量受损（IGT）的个体。由全科医生确定的具有一个或多个心血管危险因素的个人完成。所有患者均接受2小时口服葡萄糖耐量试验（OGTT）。最佳DRS截止计算通过应用receiver-operating characteristic curve.RESULTS - Qverall，1.377人年龄在55和75岁之间接受OGTT和完成DRS。平均DRS值显示出显着的变化，根据葡萄糖代谢类别，如下：正常血糖个体为8.7 +/- 3.0，空腹血糖受损个体为9.5 +/- 3.1。9.9 IGT患者为+/- 3.3，2型糖尿病患者为12.0 +/- 3.5。受试者工作特征曲线显示，以9为界值，DRS检测糖代谢异常（2型糖尿病或IGT）的敏感性为77%，特异性为45%。使用DRS作为所有初始筛选工具，然后测量评分>= 9的个体的空腹血糖，以及空腹血糖在5.6和6.9 mmol/l之间的OGTT个体，将导致识别83%的2型糖尿病病例受试者和57%的IGT病例受试者，在OGTT的成本为38%的样本和空腹血糖，在64%.CONCLUSION-DRS可以代表一个有效的廉价的工具，机会性筛选和一个有用的替代不加选择的空腹血糖测量，不容易在一般的做法。
OBJECTIVE- To evaluate all opportunistic screening strategy addressed to Individuals with one or more cardiovascular risk factor, based on the Diabetes Risk Score (DRS) as the initial instrument, for the identification of individuals with type 2 diabetes or Impaired glucose tolerance (IGT).RESEARCH DESIGN AND METHODS - The DRS, a simple self-administered questionnaire, was completed by individuals identified by general practitioners and presenting with one or more cardiovascular risk factor. All patients underwent a 2-h oral glucose tolerance test (OGTT). The optimal DRS cutoff was calculated by applying the receiver-operating characteristic curve.RESULTS - Qverall, 1.377 individuals aged between 55 and 75 years received an OGTT and completed the DRS. Mean DRS values showed a marked variation according to glucose metabolism categories, as follows: 8.7 +/- 3.0 in nomioglycemic individuals, 9.5 +/- 3.1 in individuals with Impaired Fasting glucose. 9.9 +/- 3.3 in Individuals with IGT, and 12.0 +/- 3.5 in individuals with type 2 diabetes. The receiver-operating characteristic curve showed that, With a cutoff of 9, the sensitivity of DRS in detecting individuals With glucose abnormalities (type 2 diabetes or IGT) was 77% and the specificity 45%. The use of the DRS as all initial Screening instrument, followed by the measurement of fasting blood glucose in individuals wit h a score >= 9 and by the OGTT Individuals with a fasting blood glucose between 5.6 and 6.9 mmol/l, would lead to the identification of 83% of the case subjects with type 2 diabetes and 57% of the case subjects with IGT, at a cost of an OGTT in 38% of the sample and,I fasting blood glucose in 64%.CONCLUSIONS - The DRS can represent a valid inexpensive instrument for opportunistic screening and a useful alternative to indiscriminate Fasting blood glucose measurement, not readily available in general practice.