Skip to main content
Log in

Blood glucose monitoring in the normal population: the PREDICA study

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. 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

    Article  PubMed  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. Atkins RC, Zimmet P (2010) Diabetic kidney disease: act now or pay later. Acta Diabetol 47(1):1–4

    Article  PubMed  Google Scholar 

  5. Greco D, Gambina F, Maggio F (2009) Ophthalmoplegia in diabetes mellitus: a retrospective study. Acta Diabetol 46(1):23–26

    Article  PubMed  Google Scholar 

  6. International Diabetes Federation (2006) Diabetes Atlas, 3rd edn. http://www.eatlas.idf.org

  7. Aroda VR, Ratner R (2008) Approach to the patient with prediabetes. J Clin Endocrinol Metab 93:3259–3265

    Article  PubMed  CAS  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  CAS  Google Scholar 

  11. 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

    Article  PubMed  CAS  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. Diabetes Prevention Program Research Group (2007) The prevalence of rethinopaty in impaired glucose tolerance in the Diabetes Prevention Program. Diabet Med 24:137–144

    Article  Google Scholar 

  14. 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

    Article  PubMed  CAS  Google Scholar 

  15. 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

    PubMed  Google Scholar 

  16. American Diabetes Association (2008) Standards of medical care in diabetes–2008. Diabetes Care 31(suppl 1):S12–S54

    Article  Google Scholar 

  17. 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

    Article  PubMed  CAS  Google Scholar 

  18. 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

    Article  PubMed  CAS  Google Scholar 

  19. 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

  20. 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

    Article  Google Scholar 

  21. 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

    Article  PubMed  Google Scholar 

  22. 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

    Article  CAS  Google Scholar 

  23. 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

    Article  PubMed  CAS  Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. 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

    Article  PubMed  CAS  Google Scholar 

  26. Larson-Cohn U (1976) Differences between capillary and venous blood glucose during oral glucose tolerance test. Scand J Clin Lab Invest 36:805–808

    Article  Google Scholar 

  27. 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

    PubMed  CAS  Google Scholar 

  28. 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

    Article  PubMed  CAS  Google Scholar 

  29. 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

    Article  PubMed  CAS  Google Scholar 

  30. 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

    Article  PubMed  CAS  Google Scholar 

  31. 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

    Article  PubMed  Google Scholar 

  32. Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet 365:1415–1428

    Article  PubMed  CAS  Google Scholar 

  33. 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

    Article  PubMed  CAS  Google Scholar 

  34. Dankner R, Geulayov G, Olmer L, Kaplan G (2009) Undetected type 2 diabetes in older adults. Age Ageing 38:56–62

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the Roche Diagnostics for providing of meters and strips. No other conflict of interest is declared.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Pozzilli.

Additional information

N. Napoli and F. Costanza have contributed equally to the manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-010-0212-6

Keywords

Navigation