Lina Zabulienė, Birutė Pauliukienė, Jurgita Urbonienė, Rimantas Stukas
Aims: Diabetes is a growing unsolved public health problem all over the world. Many of individuals with type 2 diabetes remain unidentified for years because of its silent course. Screening for diabetes by measuring fasting blood glucose or performing oral glucose tolerance test is the main measure of diabetes secondary prevention. This study aimed to assess the rate of impaired glucose regulation (IGR), to examine gender differences in fasting plasma glucose (FPG), 2 h post-load plasma glucose (2hPG) and their age trends and progression to diabetes in adults using routinely collected health care data. Methods: We conducted an analysis on results of oral glucose tolerance test (OGTT) performed at Vilnius city Antakalnio outpatient clinic from January 2011 to December 2014 and analysed data of 5933 adult patients. All anonymous data were obtained from electronic laboratory records of routine clinical care. We applied the 2006 World Health Organization criteria for diabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Results: Mean patients’ age was 54.02 ± 15.52 years. Mean FPG was 6.00 ± 0.89 mmol/l, mean 2hPG was 6.19 ± 2.25 mmol/l. Men had 0.29 mmol/l higher mean FPG level than women, and women had 0.16 mmol/l higher mean 2hPG level than men (p<0.05). Mean 2hPG concentration increased with age, but the FPG concentration remained unchanged starting from 50 years. Based on OGTT undiagnosed diabetes rate was 4.9%, isolated IFG – 25.6%, and isolated IGT – 5%, both IGT and IFG – 8.1 %. Prediabetes was 1.3 times more prevalent among men than women (p<0.0001). Repeated OGTT revealed 60 new cases of diabetes. Mean time from the first OGTT to diabetes development was 16.27 ± 10.51 months. Conclusions: Oral glucose tolerance test remains irreplaceable to diagnose impaired glucose regulation and essential diabetes prevention measure. In outpatient routine practice OGTT revealed impaired glucose regulation in 43.6% of patients. Undiagnosed diabetes rate was 4.9%. Men had higher rate of IFG and both IFG and IGT, women had higher rate of IGT. In 16.27±10.51 months 6.69% of patients’ developed diabetes. 83.3% of them had previously established IGR by OGTT.
Keyword(s): diabetes prevalence; prediabetes; undiagnosed diabetes.
Full Text: PDF