Fasting plasma glucose as initial screening for diabetes and prediabetes in irish adults: The Diabetes Mellitus and Vascular health initiative (DMVhi)

PLoS One. 2015 Apr 15;10(4):e0122704. doi: 10.1371/journal.pone.0122704. eCollection 2015.

Abstract

Objective: Type 2 diabetes has a long pre clinical asymptomatic phase. Early detection may delay or arrest disease progression. The Diabetes Mellitus and Vascular health initiative (DMVhi) was initiated as a prospective longitudinal cohort study on the prevalence of undiagnosed Type 2 diabetes and prediabetes, diabetes risk and cardiovascular risk in a cohort of Irish adults aged 45-75 years.

Research design and methods: Members of the largest Irish private health insurance provider aged 45 to 75 years were invited to participate in the study.

Exclusion criteria: already diagnosed with diabetes or taking oral hypoglycaemic agents. Participants completed a detailed medical questionnaire, had weight, height, waist and hip circumference and blood pressure measured. Fasting blood samples were taken for fasting plasma glucose (FPG). Those with FPG in the impaired fasting glucose (IFG) range had a 75gm oral glucose tolerance test performed.

Results: 122,531 subjects were invited to participate. 29,144 (24%) completed the study. The prevalence of undiagnosed diabetes was 1.8%, of impaired fasting glucose (IFG) was 7.1% and of impaired glucose tolerance (IGT) was 2.9%. Dysglycaemia increased among those aged 45-54, 55-64 and 65-75 years in both males (10.6%, 18.5%, 21.7% respectively) and females (4.3%, 8.6%, 10.9% respectively). Undiagnosed T2D, IFG and IGT were all associated with gender, age, blood pressure, BMI, abdominal obesity, family history of diabetes and triglyceride levels. Using FPG as initial screening may underestimate the prevalence of T2D in the study population.

Conclusions: This study is the largest screening study for diabetes and prediabetes in the Irish population. Follow up of this cohort will provide data on progression to diabetes and on cardiovascular outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Analysis of Variance
  • Blood Glucose / analysis*
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Chi-Square Distribution
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology
  • Fasting / blood
  • Female
  • Glucose Intolerance / blood
  • Glucose Intolerance / diagnosis
  • Glucose Intolerance / epidemiology
  • Humans
  • Insurance Carriers / statistics & numerical data
  • Ireland / epidemiology
  • Longitudinal Studies
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Obesity, Abdominal / blood
  • Obesity, Abdominal / diagnosis
  • Obesity, Abdominal / epidemiology
  • Prediabetic State / blood*
  • Prediabetic State / diagnosis
  • Prediabetic State / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sex Factors

Substances

  • Blood Glucose

Grants and funding

The DMVhi research project was funded by Vhi Healthcare. Part funding was received for the project through the EU-funded DEXLIFE ressearch program. Vhi Healthcare Ltd., provided support in the form of salaries for authors MS, ADJ, TOG & BC, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.