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The use of glucose measurements to improve screening for diabetes in clinical practice

The use of glucose measurements to improve screening for diabetes in clinical practice
The use of glucose measurements to improve screening for diabetes in clinical practice
Introduction: it is estimated that 4 million people will be living with diabetes in England by 2025. It is imperative that we can accurately identify people at risk of diabetes and target interventions to prevent its development.

Aim: to determine whether the addition of glucose measurements to the Leicester Risk Assessment Score (LRAS) improves the prediction of HbA1c ?42mmol/mol (6.0%) compared with a risk score alone, and reduces the number requiring additional tests to determine their glycaemic status.

Method: LRAS and HbA1c were assessed in 484 participants (aged 40–80 years). 184 participants recruited directly from primary care underwent a fasting glucose measurement while 300 participants recruited through advertisement to the general public attended for a random capillary glucose.

Results: a LRAS of ?17 had a sensitivity of 79.6% and specificity of 60.1% to predict the HbA1c value of ?42 mmol/mol (6.0%). The addition of a fasting glucose to the LRAS improved the explained variation in HbA1c from 20.8% with a risk score alone to 46.7%. In addition the number of people requiring further assessment of their glucose status was reduced from 43.8% to 33.2%. The addition of a random capillary glucose to the LRAS did not significantly improve the model.

Conclusions: The addition of a fasting blood glucose, but not a random capillary glucose, to the LRAS improves the prediction of HbA1c ?42mmol/mol (6.0%) and reduced the number of people who would need further diagnostic testing for diabetes
2397-6241
123-127
Nicholls, Adam R.
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Bohning, Dankmar
1df635d4-e3dc-44d0-b61d-5fd11f6434e1
Holt, Richard
d54202e1-fcf6-4a17-a320-9f32d7024393
Sharp, Patrick
c766278e-c11c-416b-8d08-004562b3681f
Nicholls, Adam R.
c3c265d6-cb79-4c4c-9d4e-354b7445df99
Bohning, Dankmar
1df635d4-e3dc-44d0-b61d-5fd11f6434e1
Holt, Richard
d54202e1-fcf6-4a17-a320-9f32d7024393
Sharp, Patrick
c766278e-c11c-416b-8d08-004562b3681f

Nicholls, Adam R., Bohning, Dankmar, Holt, Richard and Sharp, Patrick (2016) The use of glucose measurements to improve screening for diabetes in clinical practice. British Journal of Diabetes, 16 (3), 123-127. (doi:10.15277/bjd.2016.090).

Record type: Article

Abstract

Introduction: it is estimated that 4 million people will be living with diabetes in England by 2025. It is imperative that we can accurately identify people at risk of diabetes and target interventions to prevent its development.

Aim: to determine whether the addition of glucose measurements to the Leicester Risk Assessment Score (LRAS) improves the prediction of HbA1c ?42mmol/mol (6.0%) compared with a risk score alone, and reduces the number requiring additional tests to determine their glycaemic status.

Method: LRAS and HbA1c were assessed in 484 participants (aged 40–80 years). 184 participants recruited directly from primary care underwent a fasting glucose measurement while 300 participants recruited through advertisement to the general public attended for a random capillary glucose.

Results: a LRAS of ?17 had a sensitivity of 79.6% and specificity of 60.1% to predict the HbA1c value of ?42 mmol/mol (6.0%). The addition of a fasting glucose to the LRAS improved the explained variation in HbA1c from 20.8% with a risk score alone to 46.7%. In addition the number of people requiring further assessment of their glucose status was reduced from 43.8% to 33.2%. The addition of a random capillary glucose to the LRAS did not significantly improve the model.

Conclusions: The addition of a fasting blood glucose, but not a random capillary glucose, to the LRAS improves the prediction of HbA1c ?42mmol/mol (6.0%) and reduced the number of people who would need further diagnostic testing for diabetes

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More information

Accepted/In Press date: 9 August 2016
e-pub ahead of print date: 18 September 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 403967
URI: http://eprints.soton.ac.uk/id/eprint/403967
ISSN: 2397-6241
PURE UUID: 6e6d8c5d-80d9-4e07-b7aa-a0232e73e693
ORCID for Dankmar Bohning: ORCID iD orcid.org/0000-0003-0638-7106
ORCID for Richard Holt: ORCID iD orcid.org/0000-0001-8911-6744

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Date deposited: 16 Dec 2016 15:29
Last modified: 16 Mar 2024 04:07

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Contributors

Author: Adam R. Nicholls
Author: Dankmar Bohning ORCID iD
Author: Richard Holt ORCID iD
Author: Patrick Sharp

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