Eight models of screening for carbohydrate metabolic disturbances

The results of a screening for carbohydrate metabolic disturbances depend on used diagnostic criteria and a study method: determi-nation of fasting blood glucose levels alone or use of an oral glucose tolerance test (OGTT). The results of a population-based screening among the adult populations of two districts of the Moscow Region (n = 2638), which involved OGTT in 2508 persons, were used to analyze the sensitivity (Se) and specificity of different screening models (developed by WHO, ADA, and IDF and several hypothetic models) and to estimate the prevalence of type 2 diabetes mellitus (DM-2), glucose intolerance (GI), and impaired fasting glycemia (IFG). Eight screening models were considered. Choice of a screening model sub-stantially was shown to affect the prevalence of DM-2, GI, and IFG, which is attributable to a varying sensitivity of the models in detecting carbohydrate metabolic disturbances. Screening using the 1999 WHO recommendations shows the highest sensitivity in detecting DM-2 and GI but the screening model in which plasma glucose is measured only after 75-g glucose load has the least one (Se = 0.80) in identifying DM-2. According to the ADA and IDF consensus, screening may considerable reduce the number of OGTTs by 43.5% without substantially affecting the sensitivity (Se = 0.96) in detecting DM-2.

sensitivity, type 2 diabetes, screening, glycemia, Glucose intolerance, glucose metabolic disturbances, impaired fasting

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