Glucose screening and the risk of complications in Type 2 diabetes mellitus

Schellhase, Kenneth G.; Koepsell, Thomas D.; Weiss, Noel S.; Wagner, Edward H.; Reiber, Gayle E.

« Previous Next »Journal of Clinical Epidemiology
Volume 56, Issue 1 , Pages 75-80, January 2003

Glucose screening and the risk of complications in Type 2 diabetes mellitus☆

Kenneth G. Schellhase
- Corresponding author. Department of Family and Community Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. Tel.: (414) 456-8854; fax: (414) 456-6689.
- Department of Family Medicine, University of Washington, Box 356390, Seattle, WA 98195, USA
- The Robert Wood Johnson Clinical Scholars Program, University of Washington, Box 357183, Seattle, WA 98195-7183, USA
- Current address: Medical College of Wisconsin Department of Family and Community Medicine and The Center for Patient Care and Outcomes Research, Milwaukee, WI.
Thomas D. Koepsell
- Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195-7236, USA
- Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195-7660, USA
- The Robert Wood Johnson Clinical Scholars Program, University of Washington, Box 357183, Seattle, WA 98195-7183, USA
- Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA
Noel S. Weiss
- Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195-7236, USA
- Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA
Edward H. Wagner
- Group Health Cooperative and the Sandy MacColl Institute for Healthcare Innovation, 1730 Minor Ave., Suite 1290, Seatle, WA 98101, USA
Gayle E. Reiber
- Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195-7236, USA
- Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195-7660, USA
- Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA
- Health Services Research and Development, Veterans Affairs Puget Sound Health System, 1660 S. Columbian Way, Seattle, WA 98108, USA

Received 31 October 2001; received in revised form 8 July 2002; accepted 26 August 2002.

Abstract

It is unknown whether glucose screening for Type 2 diabetes mellitus (DM2) reduces the risk of diabetic complications. We conducted a case-control study using 303 cases with DM2 and at least one symptomatic microvascular diabetic complication, matched 1:1 to control subjects. All subjects' blood glucose tests for the decade before the first clinical suspicion of DM2 were categorized as screening or not based on the presence of symptoms suggestive of DM2. Approximately 90% of case subjects and control subjects had been screened for diabetes. After adjusting for multiple covariates in a logistic regression model, the odds ratio of developing a complication associated with screening was 0.87 (95% confidence interval 0.38–1.98), suggesting that screening may be associated with a modest reduction in the risk of certain diabetic complications. However, the confidence limits were wide and consistent with no true benefit. Further studies are needed to establish whether the small reduction we observed is genuine.

Keywords: Mass screening, Diabetes mellitus, Outcome assessment, Case-control studies, Diabetes mellitus/complications, Diabetes mellitus/epidemiology