Screening for type 2 diabetes in primary care using a stepwise protocol: the Diabscreen study.

Abstract

To evaluate a stepwise protocol in opportunistic screening for type 2 diabetes. From 2000 to 2001, in 11 Dutch general practices (n=49,229) we invited at-risk patients during usual care for a capillary fasting plasma glucose (cFPG1) measurement. If >6.0 mmol/l, a second sample (cFPG2) was taken on another day, followed by a venous sample (vFPG) if cFPG2>6.0 mmol/l and cFPG1 or 2> or =7.0 mmol/l. Of 3724 at-risk patients invited for a cFPG1, 3335 (90%) returned for the measurement. Ultimately, in 125 (4%) of them a vFPG was measured. In 101 out of 125 patients the vFPG was > or =7.0 mmol/l, giving a positive predictive value of our protocol of 81%. A stepwise screening protocol including two subsequent capillary blood glucose measurements from a portable blood glucose meter is well applicable in screening for type 2 diabetes in primary care.