Vnitr Lek 2001, 47(3):140-145

[The prevalence of undiagnosed type 2 diabetes mellitus in consulting rooms of general practitioners].

J Vozár,: Interné oddelenie specializované na liecbu diabetes mellitus NsP, Samorín, Slovenská republika.

UNLABELLED: The aim of study was to estimate the prevalence of newly detected type 2 diabetic patients and compare it with prevalence of registered type 2 diabetic patients in the Slovak republic. The second aim was to improve the cooperation between general practitioners and diabetologists in the detection of unrecognized diabetes.

PATIENTS AND METHODS: Seventy-six general practitioners were involved in Slovak Diabetologic Detection Program. Randomly taken capillary glucose (glucometer One-Touch, Lifescan) was measured in 18,942 probands over 40 years of age with one or more risk factors for type 2 diabetes in nine regions of Slovakia during a 6-month period. When capillary glucose was over 6 mmol/l the proband was referred to one of the nine diabetologic outpatient clinics for further evaluation. The history, physical examination and fasting capillary glucose or oGTT were performed in these patients. After exclusion of previously registered diabetic patients, noncompliant patients and insufficient examinations the data were evaluated in 15,387 probands. This data were compared with the Slovak National Registry, which is based on yearly collected and evaluated data from all diabetologic outpatient clinics.

RESULTS: Newly detected (undiagnosed) type 2 diabetes was found in 444 (2.9%) and impaired fasting glucose and/or impaired glucose tolerance in 347 (2.3%) out of 15,387 probands. Data from Slovak National Registry show 9.5% type 2 diabetic patients over 40 years of age. In our detection program the number of undiagnosed type 2 diabetic patients over the age of 40 years was 2.9%. Therefore authors estimated the overall prevalence of type 2 diabetes in Slovakia over the age of 40 on 12.3% of general population in this age category (population ca 2.2 million people). When is compared prevalence of undiagnosed and registered type 2 diabetic patients it can be claimed that on three registered diabetic patients, there is one undiagnosed and one other with impaired fasting glucose and/or impaired glucose tolerance. The patients with undiagnosed diabetes and ones with impaired fasting glucose and/or impaired glucose tolerance had significantly higher body mass index and significantly higher occurrence of arterial hypertension and positive family history of diabetes compared to non-diabetic probands. Authors also achieved the second aim by establishing the collaboration between general practitioners and diabetologists in the selected nine regions of Slovakia. This relationship is essential for detection the undiagnosed diabetic patients by general practitioners and confirmation of diagnosis of diabetes as well as initiation of introductory education by diabetes specialists. Authors conclude that it is essential to actively screen for disturbances of glucose metabolism in population over 40 years old in general practice.