Screening patients with ischaemic heart disease and hypertension for undiagnosed diabetes

Abstract

Diabetes mellitus is an important condition with a significant morbidity and mortality. Up to 50% of people with diabetes may be as yet undiagnosed. Widespread population screening so far has had a low uptake and yield. This study is a cross-sectional survey screening for undiagnosed diabetes amongst patients with ischaemic heart disease (IHD) or hypertension, in a semi-rural practice in Scotland. The results produced a screening uptake of 83.7% and a yield of 3.48% for patients with IHD, and an uptake of 79.65% and a yield of 3% for hypertensive patients. To identify one new case of diabetes we had to screen 24 patients with IHD and 33 with hypertension. This was feasible within an organised review system for patients with these conditions with no additional resource implications. The study is limited by the lack of multi-ethnic mix, rural setting, relative affluence, and the existing organised chronic disease management plans in this practice. This may underestimate the yield if screening were to be extended to both groups nationally. More work is needed to see if such screening for diabetes is feasible and worthwhile on a national basis.