Abstract
In the PREdiction of DIabetes from CApillary blood glucose (PREDICA) study, we propose a novel approach based on multiple capillary blood glucose (CBG) measurements, assuming that weekly measurements performed for 2 months may be an efficient strategy to screen for diabetes. We studied 538 Caucasian subjects (247 men and 291 women) without a history of diabetes, consecutively recruited by 50 GPs from the Italian provinces of Rome and Frosinone. Subjects were asked to perform 8 fasting glucose and 8 post-prandial glucose measurements during a frame time of 2 months (Glucometer Accu-chek AVIVA Roche Diagnostics). Study subjects were 55 ± 9 years old (range 22–77 years of age), 50% were overweight and 16% obese. Fifty-eight percent of subjects have performed 13 to 16 CBG measurements during the study, 68% of subjects have performed at least 5 out of 8, both fasting and post-prandial measurements. Among 492 subjects who had at least two fasting measurements, 63.6% had normal glucose levels, 25.4% showed IFG, and 11.0% were diabetic. Considering post-prandial measurements, 74.2% had normal glucose levels, 23.0% had IGT, and 2.8% were diabetic. Combined IFG + IGT was detected in 7% of study subjects, while in 0.8% diagnosis of diabetes was confirmed with both fasting and post-prandial measurements. In this study, we found a high adherence to a novel screening strategy based on self-glucose monitoring in the general population. Our results show that multiple CBG measurements may represent a simple and efficient method for diabetes screening.
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Narayan KM, Boyle JP, Geiss LS, Saaddine JB, Thompson TJ (2006) Impact of recent increase in incidence on future diabetes burden: U.S., 2005–2050. Diabetes Care 29:2114–2116
Giugliano D, Standl E, Vilsbøll T, Betteridge J, Bonadonna R, Campbell IW, Schernthaner GH, Staels B, Trichopoulou A, Farinaro E (2009) Is the current therapeutic armamentarium in diabetes enough to control the epidemic and its consequences? What are the current shortcomings? Acta Diabetol 46(3):173–181
Nádas J, Putz Z, Fövényi J, Gaál Z, Gyimesi A, Hídvégi T, Hosszúfalusi N, Neuwirth G, Oroszlán T, Pánczél P, Vándorfi G, Winkler G, Wittmann I, Jermendy G (2009) Cardiometabolic risk and educational level in adult patients with type 1 diabetes. Acta Diabetol 46(2):159–162
Atkins RC, Zimmet P (2010) Diabetic kidney disease: act now or pay later. Acta Diabetol 47(1):1–4
Greco D, Gambina F, Maggio F (2009) Ophthalmoplegia in diabetes mellitus: a retrospective study. Acta Diabetol 46(1):23–26
International Diabetes Federation (2006) Diabetes Atlas, 3rd edn. http://www.eatlas.idf.org
Aroda VR, Ratner R (2008) Approach to the patient with prediabetes. J Clin Endocrinol Metab 93:3259–3265
Gerstein HC, Santaguida P, Raina P, Morrison KM, Balion C, Hunt D, Yazdi H, Booker L (2007) Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res Clin Pract 78:305–312
Levitan EB, Song Y, Ford ES, Liu S (2004) Is non diabetic hyperglycaemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. Arch Intern Med 164:2147–2155
Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M, Finnish Diabetes Prevention Study Group (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343–1350
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM, Diabetes Prevention Program Research Group (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403
Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW (2006) Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999–2002. Diabetes Care 29:1263–1268
Diabetes Prevention Program Research Group (2007) The prevalence of rethinopaty in impaired glucose tolerance in the Diabetes Prevention Program. Diabet Med 24:137–144
Harris MI, Klein R, Welborn TA, Knuiman MW (1992) Onset of NIDDM occurs at least 4–7 yr before clinical diagnosis. Diabetes Care 15:815–819
Norris SL, Kansagara D, Bougatsos C, Fu R (2008) Screening adults for type 2 diabetes: a review of the evidence for the U.S. Preventive Services Task Force. Ann Int Med 148:855–868
American Diabetes Association (2008) Standards of medical care in diabetes–2008. Diabetes Care 31(suppl 1):S12–S54
Puavilai G, Kheesukapan P, Chanprasertyotin S, Chantraraprasert S, Suwanvilaikorn S, Nitiyanant W, Deerochochanawong C, Benjasuratwong Y, Munsakul N, Pongchaiyaikul C, Kespechara K, Montreewasuwat N (2001) Random capillary plasma glucose measurement in the screening of diabetes mellitus in high-risk subjects in Thailand. Diabetes Res Clin Pract 51:125–131
Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553
World Health Organization/International Diabetes Federation (2006) Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of WHO/IDF consultation. http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf Accessed 28 July 2009
Sheeny AM, Coursin DB, Gabbay RA (2009) Back to Wilson and Jungner:10 Good reasons to screen for type 2 diabetes mellitus. Mayo Clin Proc 84:38–42
Zhang P, Engelgau MM, Valdez R, Benjamin SM, Cadwell B, Narayan KM (2003) Costs of screening for pre-diabetes among US adults: a comparison of different screening strategies. Diabetes Care 26:2536–2542
Ito C, Maeda R, Ishida S, Harada H, Inoue N, Sasaki H (2000) Importance of OGTT for diagnosing diabetes mellitus based on prevalence and incidence of retinopathy. Daibetes Res Clin Pract 49:181–186
Rolka DB, Narayan KM, Thompson TJ, Goldman D, Lindenmayer J, Alich K, Bacall D, Benjamin EM, Lamb B, Stuart DO, Engelgau MM (2001) Performance of recommended screening tests for undiagnosed diabetes and dysglycemia. Diabetes Care 24:1899–1903
Monnier L, Colette C, Dunseath GJ, Owens DR (2007) The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes. Diabetes Care 30:263–269
Unwin N, Shaw J, Zimmet P, Alberti KG (2002) Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med 19:708–723
Larson-Cohn U (1976) Differences between capillary and venous blood glucose during oral glucose tolerance test. Scand J Clin Lab Invest 36:805–808
Eriksson KF, Fex G, Trell E (1983) Capillary-venous differences in blood glucose values during the oral glucose tolerance test. Clin Chem 29(5):993
Kuwa K, Nakayama T, Hoshino T, Tominaga M (2001) Relationships of glucose concentrations in capillary whole blood, venous whole blood and venous plasma. Clin Chim Acta 307:187–192
Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Meigs JB, Bonadonna RC, Muggeo M (2004) Bruneck study. Population-based incidence rates and risk factors for type 2 diabetes in white individuals: the Bruneck study. Diabetes 53(7):1782–1789
Kruijshoop M, Feskens EJ, Blaak EE, de Bruin TW (2004) Validation of capillary glucose measurements to detect glucose intolerance or type 2 diabetes mellitus in the general population. Clin Chim Acta 341(1–2):33–40
Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS (2003) Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 289:76–79
Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet 365:1415–1428
Droumaguet C, Balkau B, Simon D, Caces E, Tichet J, Charles MA, Eschwege E (2006) DESIR Study Group. Use of HbA1c in predicting progression to diabetes in French men and women: data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR). Diabetes Care 29:1619–1625
Dankner R, Geulayov G, Olmer L, Kaplan G (2009) Undetected type 2 diabetes in older adults. Age Ageing 38:56–62
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The authors would like to thank the Roche Diagnostics for providing of meters and strips. No other conflict of interest is declared.
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N. Napoli and F. Costanza have contributed equally to the manuscript.
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Napoli, N., Costanza, F., Di Stasio, E. et al. Blood glucose monitoring in the normal population: the PREDICA study. Acta Diabetol 48, 29–34 (2011). https://doi.org/10.1007/s00592-010-0212-6
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DOI: https://doi.org/10.1007/s00592-010-0212-6