Prevalence of undiagnosed type-2-diabetes Mellitus and impaired fasting glucose in German primary care:: Data from the German metabolic and cardiovascular risk project (GEMCAS)
Prevalence of undiagnosed type-2-diabetes Mellitus and impaired fasting glucose in German primary care:: Data from the German metabolic and cardiovascular risk project (GEMCAS)
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DOI：
10.1055/s-2007-985359
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发表时间：
2008-01-01
影响因子：
1.8
通讯作者：
Moebus, S.
中科院分区：
文献类型：
--
作者：
Hauner, H.;Hanisch, J.;Moebus, S.
目的：初级保健医生是医疗保健系统的守门人，因此负责糖尿病的筛查、预防和治疗。关于糖尿病、空腹血糖受损的患病率以及与糖尿病和随后的心血管疾病的未来发展风险相关的因素，在接受全科医生治疗的糖尿病患者中知之甚少。全国范围内的35个样本，2005年筛查的869名初级保健患者被用来估计检出和未检出糖尿病以及空腹血糖受损的患病率。结果：（1）采用血糖筛查法，发现1型糖尿病和2型糖尿病的患病率分别为0.6%和12.2%，其中2型糖尿病的患病率为12.2%。另有2.9%（23%的诊断）未诊断糖尿病（0.9%）或空腹血糖受损（2.0%）。2)与非糖尿病患者相比，未确诊的患者具有更不利的心血管风险特征。3)此外，较高的年龄、男性、低HDL胆固醇和高甘油三酯以及糖尿病家族史与不明糖尿病或空腹血糖受损相关。结论：德国约15.7%的个体咨询初级保健医师，受糖尿病（已知和未知）或空腹血糖受损的影响，并面临心血管风险评分显著升高。这项研究表明，使用简化的血糖筛查算法，考虑到风险标志物，如较高的年龄，男性，低HDL-胆固醇，高甘油三酯和糖尿病家族史，可以很好地作为一个合适的筛查方法，为未确诊的糖尿病和空腹血糖受损的初级保健实践。
Aims: Primary care physicians are gatekeepers of the healthcare system and thus responsible for screening, prevention and treatment of diabetes. Little is known about the prevalence of diabetes, impaired fasting glucose and factors that are associated with the risk of future development of diabetes and subsequent cardiovascular disease in unselected patients presenting to general practitioners.Research Design and Methods: A nationwide sample of 35,869 primary care patients screened in 2005 was used to estimate the prevalence of detected and undetected diabetes as well as of impaired fasting glucose. Logistic regressions were used to assess the prevalence, cardiovascular morbidity and the factors associated with undetected diabetes and impaired fasting glucose.Results: 1) Using a blood glucose screening algorithm the prevalence of known type 1 and type 2 diabetes mellitus was found to be 0.6 and 12.2%, respectively. Another 2.9% (23% of the diagnosed) had either undiagnosed diabetes (0.9%) or impaired fasting glucose (2.0%). 2) Undiagnosed patients had a more unfavourable cardiovascular risk profile compared to non-diabetic patients. 3) Moreover, higher age, male gender, low HIDL-cholesterol and elevated triglycerides as well as a family history of diabetes were associated with unknown diabetes or impaired fasting glucose.Conclusions: Approximately 15.7%of individuals in Germany consulting a primary care physician are affected from either diabetes (known and unknown) or impaired fasting glucose and face a substantially elevated cardiovascular risk score. This study demonstrated that using a simplified blood glucose screening algorithm considering risk markers like higher age, male gender, low HDL-cholesterol, high triglycerides and a family history of diabetes may well serve as a suitable screening approach for undiagnosed diabetes and impaired fasting glucose in primary care practice.