INTRODUCTION. The main objective of this screening survey was to determine the prevalence of undiagnosed diabetes mellitus (DM), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) and to evaluate the distribution of diabetes risk factors in primary care population aged 45 or more in Poland.
MATERIAL AND METHODS. Each general practitioner participating in the study, selected 100 consecutive patients aged 45 or more. Patients were asked to fill in the „Self-evaluation questionnaires”. High risk patients (at least two symptoms or two risk factors or one symptom and one risk factor including age) were qualified to the random capillary blood glucose (RCBG) measurement. Patients with RCBG level below 100 mg/dl (5.5 mmol/l) were considered as nondiabetics. Patients with RCBG level ≥ 200 mg/dl (11.1 mmol/l) were considered to be diabetic. Those with RCBG ≥ 100 mg/dl but < 200 mg/dl were offered fasting plasma glucose measurement (FPG) and further were screened for diabetes according to European Diabetes Policy Group 1998-1999 and WHO 1999 guidelines.
RESULTS. 127 primary care physicians from all over the country participated in the study. 12 446 patients returned „Self-evaluation questionnaires”. 10.2% patients in this group had previously diagnosed diabetes mellitus. 11 418 patients over 45 years old were included into the statistical analysis, out of 11 900 patients participating in the study. Finally the prevalence of undiagnosed DM, IFG and IGT was 5.4%, 1.7% and 1.3% respectively. In patients with newly diagnosed glucose metabolism disturbances (DM + + IFG + IGT), frequency of diabetes risk factors (BMI ≥ 25 kg/m2, WHR > 0,85 in women and WHR > 0,9 in men, family history of DM, hypertension, dyslipidemia, previously identified hiperglycemia, in women: delivery of a baby weighing > 4.5 kg) was significantly higher (p < 0.001) than in patients without disturbances in glucose metabolism.
CONCLUSIONS
1. Previously undiagnosed diabetes mellitus was discovered in 5,4% of the primary care population over 45 years old. Prediabetic state — IFG or IGT — was found in 1.7% and 1.3% respectively.
2. Patients with known and unknown diabetes constituted as much as 15.6% of total number of patients (over 45 years old) treated by primary care physicians and this group of physicians was dealing with 18.6% patients with carbohydrate disturbances.
3. Physicians found „Self-evaluation questionnaires” for patients as feasible and helpful in the screening for diabetes risk factors and symptoms. Diagnostic pathway proposed in the study, was evaluated as easy to implement in general practice.