Article

Diabetologia

, Volume 55, Issue 12, pp 3238-3244

Implementation of the automated Leicester Practice Risk Score in two diabetes prevention trials provides a high yield of people with abnormal glucose tolerance

  • L. J. GrayAffiliated withDepartment of Health Sciences, University of Leicester, Leicester Diabetes Centre (Broadleaf), Leicester General Hospital Email author 
  • , K. KhuntiAffiliated withDepartment of Health Sciences, University of Leicester, Leicester Diabetes Centre (Broadleaf), Leicester General Hospital
  • , C. EdwardsonAffiliated withLeicester Diabetes Centre, Leicester General Hospital
  • , S. GoldbyAffiliated withLeicester Diabetes Centre, Leicester General Hospital
  • , J. HensonAffiliated withLeicester Diabetes Centre, Leicester General Hospital
  • , D. H. MorrisAffiliated withDepartment of Cardiovascular Sciences, University of Leicester
  • , D. SheppardAffiliated withDepartment of Health Sciences, University of Leicester, Leicester Diabetes Centre (Broadleaf), Leicester General Hospital
  • , D. WebbAffiliated withDepartment of Cardiovascular Sciences, University of Leicester
  • , S. WilliamsAffiliated withLeicester Diabetes Centre, Leicester General Hospital
    • , T. YatesAffiliated withDepartment of Cardiovascular Sciences, University of Leicester
    • , M. J. DaviesAffiliated withDepartment of Cardiovascular Sciences, University of Leicester

Abstract

Aims/hypothesis

The Leicester Practice Risk Score (LPRS) is a tool for identifying those at high risk of either impaired glucose regulation (IGR), defined as impaired glucose tolerance and/or impaired fasting glucose, or type 2 diabetes from routine primary care data. The aim of this study was to determine the yield from the LPRS when applied in two diabetes prevention trials.

Methods

Let’s Prevent Diabetes (LPD) and Walking Away from Diabetes (WAD) studies used the LPRS to identify people at risk of IGR or type 2 diabetes from 54 general practices. The top 10% at risk within each practice were invited for screening using a 75 g OGTT. The response rate to the invitation and the prevalence of IGR and/or type 2 diabetes in each study were calculated.

Results

Of those invited 19.2% (n = 3,449) in LPD and 22.1% (n = 833) in WAD attended. Of those screened for LPD 25.5% (95% CI 24.1, 27.0) had IGR and 4.5% (95% CI 3.8, 5.2) had type 2 diabetes, giving a prevalence of any abnormal glucose tolerance of 30.1% (95% CI 28.5, 31.6). Comparable rates were seen for the WAD study: IGR 26.5% (95% CI 23.5, 29.5), type 2 diabetes 3.0% (95% CI 1.8, 4.2) and IGR/type 2 diabetes 29.5% (95% CI 26.4, 32.6).

Conclusions/interpretation

Using the LPRS identifies a high yield of people with abnormal glucose tolerance, significantly higher than those seen in a population screening programme in the same locality. The LPRS is an inexpensive and simple way of targeting screening programmes at those with the highest risk.

Keywords

Impaired glucose regulation Prevalence Primary care Screening Type 2 diabetes