Abstract:
BACKGROUND:With positive results from diabetes prevention studies, there is interest in convenient ways to incorporate screening for glucose intolerance into routine care and to limit the need for fasting diagnostic tests. OBJECTIVE:The aim of this study is to determine whether random plasma glucose (RPG) could be used to screen for glucose intolerance. DESIGN:This is a cross-sectional study. PARTICIPANTS:The participants of this study include a voluntary sample of 990 adults not known to have diabetes. MEASUREMENTS:RPG was measured, and each subject had a 75-g oral glucose tolerance test several weeks later. Glucose intolerance targets included diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose(110) (IFG(110); fasting glucose, 110-125 mg/dl, and 2 h glucose < 140 mg/dl). Screening performance was measured by area under receiver operating characteristic curves (AROC). RESULTS:Mean age was 48 years, and body mass index (BMI) was 30.4 kg/m(2); 66% were women, and 52% were black; 5.1% had previously unrecognized diabetes, and 24.0% had any "high-risk" glucose intolerance (diabetes or IGT or IFG(110)). The AROC was 0.80 (95% CI 0.74-0.86) for RPG to identify diabetes and 0.72 (0.68-0.75) to identify any glucose intolerance, both highly significant (p < 0.001). Screening performance was generally consistent at different times of the day, regardless of meal status, and across a range of risk factors such as age, BMI, high density lipoprotein cholesterol, triglycerides, and blood pressure. CONCLUSIONS:RPG values should be considered by health care providers to be an opportunistic initial screening test and used to prompt further evaluation of patients at risk of glucose intolerance. Such "serendipitous screening" could help to identify unrecognized diabetes and prediabetes.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Ziemer DC,Kolm P,Foster JK,Weintraub WS,Vaccarino V,Rhee MK,Varughese RM,Tsui CW,Koch DD,Twombly JG,Narayan KM,Phillips LSdoi
10.1007/s11606-008-0524-1subject
Has Abstractpub_date
2008-05-01 00:00:00pages
528-35issue
5eissn
0884-8734issn
1525-1497journal_volume
23pub_type
杂志文章abstract:BACKGROUND:Seasonal influenza vaccination is recommended for all adults; however, little is known about how primary care physicians can communicate effectively with patients about influenza vaccination. OBJECTIVE:To assess among general internal medicine (GIM) and family physicians (FP) regarding adult influenza vacci...
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更新日期:2019-10-01 00:00:00
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journal_title:Journal of general internal medicine
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2009-01-01 00:00:00
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