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ISSN 1527-3172 (Electronic)

2013, Number 2

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MEDICC Review 2013; 15 (2)

Diabetes risk in a Cuban primary care Setting in persons with no known glucose abnormalities

Naranjo AA, Rodríguez ÁY, Llera RE, Aroche R

Language: English
References: 37
Page: 16-19
PDF size: 129.45 Kb.


ABSTRACT

Introduction: With 333 million cases worldwide predicted for 2015, type 2 diabetes mellitus presents an important global health challenge. Its rising tide calls for health policies emphasizing prevention at the primary care level, including public education as well as early risk identification and intervention.
Objetive: Estimate risk of developing type 2 diabetes in persons with no known glucose abnormalities, registered in a primary care setting in Pinar del Río city, Cuba, using FINDRISK.
Methods: A descriptive, cross-sectional study applied FINDRISK to 620 persons aged U 18 years randomly selected from a universe of 1058 patients with no known glucose abnormalities, registered in family-doctor-and-nurse office No. 23 in the Turcios Lima Teaching Polyclinic health area, Pinar del Río city.
Results: The study population was predominantly aged ≤ 45 years (53.5%) and 80.2% was overweight or obese. At least moderate risk of diabetes was found in 74.4% of the sample, and 10.5% was at very high risk, meaning an estimated 120 patients in the sample could be expected to develop type 2 diabetes within the next 10 years.
Conclusions: Type 2 diabetes prevalence can be expected to increase substantially in this population over the next decade. We recommend design and timely implementation of intensive lifestyle change programs to eliminate or slow development of type 2 diabetes in at-risk individuals. We propose following cohorts identified by FINDRISK to assess its prognostic value in the Cuban population.


REFERENCES

  1. Rydén L, Standl E, Bartnik M, Van der Berghe G, Betteridge J, de Boer MJ, et al. Guidelines on diabetes, pre-diabetes and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J. 2007 Jan;28(1):88–136.

  2. National Health Statistics and Medical Records Division (CU). Anuario Estadístico de Salud 2011. Havana: Ministry of Public Health (CU); 2012. Spanish.

  3. National Health Statistics and Medical Records Division (CU). Indicadores básicos de salud en Cuba 2011 [Internet]. Havana: Ministry of Public Health (CU); 2012 [cited 2012 Nov 10]. Available from: http://www.sld.cu/sitios/dne/. Spanish.

  4. Talmud PJ, Hingorani AD, Cooper JA, Marmot MG, Brunner EJ, Kumari M, et al. Utility of genetic and non-genetic risk factors in prediction of type 2 diabetes: Whitehall II prospective cohort study. BMJ. 2010 Jan 1;340:b4838.

  5. Bell RA, Mayer-Davis EJ, Beyer JW, D’Agostino RB Jr, Lawrence JM, Linder B, et al. Diabetes in non-Hispanic white youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes Care. 2009 Mar;32 Suppl 2:S102–11.

  6. The Diabetes Prevention Program Research Group. The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: an intent-to-treat analysis of the DPP/DPPOS. Diabetes Care. 2012 Apr;35(4):723–30.

  7. Fonseca VA, Kirkman MS, Darsow T, Ratner RE. The American Diabetes Association diabetes research perspective. Diabetes Care. 2012 Jun;35(6):1380–7.

  8. Ackermann RT, Finch EA, Brizendine E, Zhou H, Marrero DG. Translating the Diabetes Prevention Program into the community. The DEPLOY Pilot Study. Am J Prev Med. 2008 Oct;35(4):357–63.

  9. DePalma MT, Rollison J, Camporese M. Psychosocial predictors of diabetes management. Am J Health Behav. 2011Mar–Apr;35(2):209–18.

  10. Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metr. 2010 Oct 22;8:29.

  11. Heikes KE, Eddy DM, Arondekar B, Schlessinger L. Diabetes risk calculator: a simple tool for detecting undiagnosed diabetes and pre-diabetes. Diabetes Care. 2008 May;31(5):1040–5.

  12. Aekplakorn W, Bunnag P, Woodward M, Sritara P, Cheepudomwit S, Yamwong S, et al. A risk score for predicting incident diabetes in the Thai population. Diabetes Care. 2006 Aug;29(8):1872–7.

  13. Stern MP, Williams K, Haffner SM. Identifi cation of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Ann Intern Med. 2002 Apr 16;136(8):575–81.

  14. Glümer C, Carstensen B, Sandbaek A, Lauritzen T, Jørgensen T, Borch-Johnsen K; inter99 study. A Danish diabetes risk score for targeted screening: the Inter99 study. Diabetes Care. 2004 Mar;27(3):727–33.

  15. Balkau B, Lange C, Fezeu L, Tichet J, de Lauzon- Guillain B, Cezernichow S, et al. Predicting diabetes: clinical, biological, and genetic approaches. Diabetes Care. 2008 Oct;31(10):2056–61.

  16. Cabrera de León A, Coello SD, Rodríguez Pérez MC, Medina MB, Almeida González D, Díaz BB, et al. A simple clinical score for type 2 diabetes mellitus screening in the Canary Islands. Diabetes Res Clin Pract. 2008 Apr;80(1):128–33.

  17. Vivek CKS, Prabhakaran RD, Jeemon P, Ramakrishnan L, Shah P, Shah B. Development of a clinical risk score in predicting undiagnosed diabetes in urban Asian Indian adults: a populationbased study. CVD Prevention and Control. 2008 Sep;3(3):141–51.

  18. Glümer C, Vistisen D, Borch-Johnsen K, Colagiuri S; DETECT-2 Collaboration. Risk scores for type 2 diabetes can be applied in some populations but not all. Diabetes Care. 2006 Feb;29(2):410–4.

  19. Ramachandran A, Snehalatha C, Vijay V, Wareham NJ, Colagiuri S. Derivation and validation of diabetes risk score for urban Asian Indians. Diabetes Res Clin Pract. 2005 Oct;70(1):63–70.

  20. Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplifi ed Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005 Sep;53:759–63.

  21. Al-Lawati JA, Tuomilehto J. Diabetes risk score in Oman: a tool to identify prevalent type 2 diabetes among Arabs of the Middle East. Diabetes Res Clin Pract. 2007 Sep;77(3):438–44.

  22. Xie J, Hu D, Yu D, Chen CS, He J, Gu D. A quick self-assessment tool to identify individuals at high risk of type 2 diabetes in the Chinese general population. J Epidemiol Community Health. 2010 Mar;64(3):236–42.

  23. Waugh N, Scotland G, McNamee P, Gillett M, Brennan A, Goyder E, et al. A Screening for type 2 diabetes: literature review and economic modelling. Health Technol Assess. 2007;11:1–125.

  24. Balkau B, Lange C, Fezeu L, Tichet J, de Lauzon- Guillain B, Czernichow S, et al. Predicting diabetes: clinical, biological, and genetic approaches: data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR). Diabetes Care. 2008 Oct;31(10):2056–61.

  25. Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003 Mar;26(3):725–31.

  26. García R, Suárez R. La educación a personas con diabetes mellitus en la atención primaria de salud. Rev Cubana Endocrinol [Internet] 2007 [cited 2012 Nov 10];18(1). Available from: http:// bvs.sld.cu/revistas/end/vol18_1_07/end05107 .htm. Spanish.

  27. American Diabetes Association. Diagnosis and classifi cation of diabetes mellitus. Diabetes Care. 2012;35 (Suppl 1):S64–71.

  28. Vermunt PW, Milder IE, Wielaard F, van Oers JA, Westert GP. An active strategy to identify individuals eligible for type 2 diabetes prevention by lifestyle intervention in Dutch primary care: the APHRODITE study. Fam Pract. 2010 Jun;27(3):312–9.

  29. Saaristo T, Peltonen M, Lindström J, Saarikoski L, Sundvall J, Eriksson JG, et al. Crosssectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome. Diab Vasc Dis Res. 2005 May;2(2):67–72.

  30. Rathmann W, Martin S, Haastert B, Icks A, Holle R, Löwel H, et al. Performance of screening questionnaires and risk scores for undiagnosed diabetes: the KORA Survey 2000. Arch Intern Med. 2005 Feb 28;165(4):436–41.

  31. Waugh N, Scotland G, McNamee P, Gillett M, Brennan A, Goyder E, et al. A Screening for type 2 diabetes: literature review and economic modelling. Health Technol Assess. 2007 May;11(17):1–125.

  32. Klein Woolthuis EP, de Grauw WJ, van Gerwen WH, van den Hoogen HJ, van de Lisdonk EH, Metsemakers JF, et al. Identifying people at risk for undiagnosed type 2 diabetes using the GP’s electronic medical record. Fam Pract. 2007 Jun;24(3):230–6.

  33. Rahman M, Simmons RK, Harding AH, Wareham NJ, Griffi n SJ. A simple risk score identifi es individuals at high risk of developing type 2 diabetes: a prospective cohort study. Fam Pract. 2008 Jun;25(3):191–6.

  34. National Health Statistics and Medical Records Division (CU). Anuario Estadístico de Salud 2010. Havana: Ministry of Public Health (CU); 2011. Spanish.

  35. Bonné Moreno V, González Löwenberg O, Charques Velasco E, Alonso Martínez MM. Riesgo coronario y prescripción en pacientes con hipercolesterolemia en atención primaria. Aten Primaria. 2000 Mar 15;25(4):209–13. Spanish.

  36. Franciosi M, De Berardis G, Rossi MC, Sacco M, Belfi glio M, Pellegrini F, et al. Use of the diabetes risk score for opportunistic screening of undiagnosed diabetes and impaired glucose tolerance: the IGLOO (Impaired Glucose Tolerance and Long-Term Outcomes Observational) study. Diabetes Care. 2005 May;28(5):1187–94.

  37. Hippisley-Cox J, Coupland C, Robson J, Sheikh A, Brindle P. Predicting risk of type 2 diabetes in England and Wales: prospective derivation and validation of QDScore. BMJ. 20 09 Mar 17;338:b880.




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