Screening for Type 2 Diabetes and Impaired Glucose Metabolism
Open accessAbstract
OBJECTIVE—To assess the Australian protocol for identifying undiagnosed type 2 diabetes and impaired glucose metabolism. RESEARCH DESIGN AND METHODS—The Australian screening protocol recommends a stepped approach to detecting undiagnosed type 2 diabetes based on assessment of risk status, measurement of fasting plasma glucose (FPG) in individuals at risk, and further testing according to FPG. The performance of and variations to this protocol were assessed in a population-based sample of 10,508 Australians. RESULTS—The protocol had a sensitivity of 79.9%, specificity of 79.9%, and a positive predictive value (PPV) of 13.7% for detecting undiagnosed type 2 diabetes and sensitivity of 51.9% and specificity of 86.7% for detecting impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). To achieve these diagnostic rates, 20.7% of the Australian adult population would require an oral glucose tolerance test (OGTT). Increasing the FPG cut point to 6.1 mmol/l (110 mg/dl) or using HbA1c instead of FPG to determine the need for an OGTT in people with risk factors reduced sensitivity, increased specificity and PPV, and reduced the proportion requiring an OGTT. However, each of these protocol variations substantially reduced the detection of IGT or IFG. CONCLUSIONS—The Australian screening protocol identified one new case of diabetes for every 32 people screened, with 4 of 10 people screened requiring FPG measurement and 1 in 5 requiring an OGTT. In addition, 1 in 11 people screened had IGT or IFG. Including HbA1c measurement substantially reduced both the number requiring an OGTT and the detection of IGT or IFG.
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Even lowering the cutoff value to 5.3% resulted in a sensitivity of only 78% among individuals with at least one risk factor in an Australian national population study.
“Even lowering the cutoff value to 5.3%, resulted in a sensitivity of only 78% among individuals with at least one risk factor in a study conducted in Australia national population [38].”
From A Novel Testing Model for Opportunistic Screening of Pre-Diabetes and Diabetes among U.S. Adults (2015) · cites this paper as [38]
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- Authors
- Colagiuri, S., Hussain, Z., Zimmet, P., Cameron, A., & Shaw, J.
- Affiliations
- Prince of Wales Hospital (AU)
- International Diabetes Institute, Caufield, Victoria, Australia
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2004-02-01
- Volume
- 27
- Issue
- 2
- Pages
- 367-371
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2163157019
- Cited by
- 100
- References
- 15
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 1 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 7 · 2014: 4 · 2013: 7 · 2012: 8
- FWCI
- 4.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Funders
- U.S. Department of Health and Human Services
- Eli Lilly and Company
- Diabetes Australia Research Trust
- Queensland Health
- Diabetes Australia
- Kidney Health Australia
- Servier
- Tasmanian Department of Health
- Merck Sharp and Dohme
- Cilag
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- type 2 diabetes screening, impaired glucose tolerance, impaired fasting glucose, fasting blood glucose, oral glucose tolerance test, HbA1c, sensitivity and specificity, risk factors, mass screening
- MeSH terms
- Australia, Blood Glucose, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Mass Screening, Middle Aged, Risk Factors, Glucose Intolerance
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