Screening for Type 2 diabetes mellitus in the UK Indo‐Asian population

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Abstract
Summary: Aims Type 2 diabetes mellitus (DM) has a high prevalence in Asian subjects. A simple method of screening using self‐testing for postprandial glycosuria achieved a good response rate and a sensitivity which compared favourably to more expensive and invasive methods in a semirural Caucasian population. We examined its effectiveness in Asian subjects. Methods Caucasian and Indo‐Asian subjects aged 35–70 years in two general practices in Leicester (n = 9896 (6198 = Asian subjects, 3698 = Caucasian)) were screened. Those known to have diabetes were excluded. Subjects were asked to self‐test for glycosuria 1 h after their main meal. Instruction and response cards were translated in Punjabi and Gujarati and sent to the Asian subjects, depending on age and surname. Results Response rate was 34.4% in Asian subjects compared to 54.0% in Caucasian subjects. Prevalence of glycosuria was 8.2% in Asian subjects and 3.2% in Caucasian subjects. Two hundred and thirty‐nine subjects recorded glycosuria and 202 (84.5% of the total, 86.9% of Asian subjects, 78.1% of Caucasian) attended for oral glucose tolerance test (OGTT). Sixty‐three (31.2%) were found to have diabetes (46, 73% Asian), 29 (14.4%) impaired glucose tolerance (24, 82.8% Asian) and 110 (54.4%) normal glucose tolerance (82, 74.6% Asian). Thus 30% of Asian subjects and 34% of Caucasian subjects had diabetes on OGTT. The prevalence of diabetes in 35–70 years in the total population after screening was 5.6% (6.8% in Asian subjects, 3.6% in Caucasian) and in the screened population was 12.7% (17.9% in Asian subjects, 6.3% in Caucasian). Conclusions Screening for diabetes using this method, in terms of response rate, is not as effective in a large city setting, particularly in the Asian population. However, the yield of diabetes in the age group 35–64 years compares well to much more expensive and labour intensive approaches and its use in this population in a primary care setting is justified.Diabet. Med. 16, 131–137 (1999)