Τίτλος:
Two-stage, school and community-based population screening successfully identifies individuals and families at high-risk for type 2 diabetes: The Feel4Diabetes-study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: The implementation of population screening and early prevention strategies targeting individuals at high-risk for type 2 diabetes (T2D) seems to be a public health priority. The current work aimed to describe the screening procedure applied in the Feel4Diabetes-study and examine its effectiveness in identifying individuals and families at high risk, primarily for T2D and secondarily for hypertension, among vulnerable populations in low to middle-income countries (LMICs) and high-income countries (HICs) across Europe. Methods: A two-stage screening procedure, using primary schools as the entry-point to the community, was applied in low socioeconomic status (SES) regions in LMICs (Bulgaria-Hungary), HICs (Belgium-Finland) and HICs under austerity measures (Greece-Spain). During the first-stage screening via the school-setting, a total of 20,501 parents (mothers and/or fathers) of schoolchildren from 11,396 families completed the Finnish Diabetes Risk Score (FINDRISC) questionnaire, while their children underwent anthropometric measurements in the school setting. Parents from the identified "high-risk families" (n = 4484) were invited to participate in the second-stage screening, including the measurement of fasting plasma glucose (FPG) and blood pressure (BP). In total, 3153 parents participated in the second-stage screening (mean age 41.1 ± 5.6 years, 65.8% females). Results: Among parents who attended the second-stage screening, the prevalence of prediabetes (as defined by impaired fasting glucose; FPG 100-125 mg/dl) and T2D (FPG > 126 mg/dl) was 23.2 and 3.0% respectively, and it was found to be higher in the higher FINDRISC categories. The percentage of undiagnosed T2D among the participants identified with T2D was 53.5%. The prevalence of high normal BP (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg) and hypertension (systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg) was 14 and 18.6% respectively, which was also higher in the higher FINDRISC categories. The percentage of cases not receiving antihypertensive treatment among the participants identified with hypertension was 80.3%. Conclusion: The findings of the current study indicate that the two-stage school and community-based screening procedure followed, effectively identified high-risk individuals and families in vulnerable populations across Europe. This approach could be potentially scalable and sustainable and support initiatives for the early prevention of T2D and hypertension. Trial registration: The Feel4Diabetes-intervention is registered at http://clinicaltrials.gov/(NCT02393872; date of trial registration: March 20, 2015). © 2020 The Author(s).
Συγγραφείς:
Manios, Y.
Mavrogianni, C.
Lambrinou, C.-P.
Cardon, G.
Lindström, J.
Iotova, V.
Tankova, T.
Civeira, F.
Kivelä, J.
Jancsó, Z.
Shadid, S.
Tsochev, K.
Mateo-Gallego, R.
Radó, S.
Dafoulas, G.
Makrilakis, K.
Androutsos, O.
Περιοδικό:
BMC Endocrine Disorders
Εκδότης:
BioMed Central Ltd.
Λέξεις-κλειδιά:
glucose, adult; anthropometry; antihypertensive therapy; Article; blood pressure measurement; child; controlled study; diagnostic error; diastolic blood pressure; disease control; Europe; fasting; female; Finnish Diabetes Risk Score; glucose blood level; high income country; high risk population; human; hypertension; impaired glucose tolerance; low income country; major clinical study; male; mass screening; middle income country; non insulin dependent diabetes mellitus; prevalence; primary school; public health service; school child; social status; systolic blood pressure; vulnerable population; clinical trial; community care; demography; family; feasibility study; impaired glucose tolerance; middle aged; multicenter study; non insulin dependent diabetes mellitus; organization and management; preventive health service; procedures; program evaluation; randomized controlled trial; risk factor; school; school health service, Adult; Child; Community Networks; Diabetes Mellitus, Type 2; Europe; Family; Feasibility Studies; Female; Humans; Implementation Science; Male; Mass Screening; Middle Aged; Prediabetic State; Prevalence; Preventive Health Services; Program Evaluation; Residence Characteristics; Risk Factors; School Health Services; Schools; Vulnerable Populations
DOI:
10.1186/s12902-019-0478-9
