The rising tide of diabetes (DM) calls for strategies applicable at large scale to anticipate diagnosis at the earliest disease stages. However, no conclusive evidence exists on the most effective DM screening program. We tested whether random capillary blood glucose (RCBG), a validated DM risk questionnaire (FINDRISC), or both, may be applied as universal screening strategy in a 4-year (2015-18) multi-center study involving all individuals presenting to the information desks during the World Diabetes Day and similar initiatives in two metropolitan areas of Northern Italy. In case of high FINDRISC scores (>14 points) and/or RCGB levels suggestive for DM (≥200 mg/dL within 2h after last meal/sugar drink;≥150 mg/dL within 2-5h; ≥125 mg/dL, >5h), people were invited to the Diabetes Center (DC) for laboratory confirmation by fasting plasma glucose and A1c. The FINDRISC was also advertised on newspapers and flyers in squares, hospitals and pharmacies of both cities. Overall, 62,827 flyers were distributed and ∼400.000 inhabitants were exposed to the advertisements. Eventually, 154 individuals reporting high FINDRISC scores presented for a laboratory check and diagnosis was confirmed in 18 (11.7%). Among 8,563 individuals undergoing RCBG, 341 (4%) had glucose levels suggestive for DM; 86 had a laboratory check and DM was confirmed in 36 (41.9%). In addition to RCBG, 3,351 subjects also completed the FINDRISC and 480 (14.3%) reported high scores. Of them, 397 (82.7%) presented to the DC and 40 (10.1%) had diagnosis confirmed. In 30 individuals, both FINDRISC and RCBG were suggestive for DM and diagnosis was confirmed in 17/27 subjects eventually presented to the DC (63.0%). These data suggest that RCBG outperforms FINDRISC to identify unknown DM. The simultaneous presence of FINDRISC and RCBG suggestive for DM appears even more effective. Poor adherence to laboratory check in high-risk cases calls for initiatives to raise public awareness on the deleterious concequences of untreated DM.
M. Dauriz: None. E. Bonora: Advisory Panel; Self; Lilly Diabetes, Novartis AG, Sanofi. Speaker’s Bureau; Self; Abbott, Lilly Diabetes, Novo Nordisk A/S, Sanofi.
Italian Ministry of Health (RF-2011-02350193)