gms | German Medical Science

Type 2 diabetes is often diagnosed accidentally quite some time after onset. To improve this situation screening-methods for detecting prediabetes are needed, which will allow a most accurate assessment of impaired glucose tolerance (IGT) with minimal efforts required. The OGTT is considered the best method for identifying IGT. However OGTT requires a lot of time and effort and therefore it is not being used routinely in daily practice.

To find a set of clinical and/or laboratory parameters which will help to assess prediabetes with the highest possible reliability in normal clinical practice.

A prospective multicenter study supported by an unrestricted grant of Aventis Pharma Germany. Inclusion criteria were as follows: Age > 18 ys, capillary blood fasting glucose 100-130 mg/dl (Stix/Sensor-Test) and at least one additional risk factor for e.g. hypertension, family history of diabetes, BMI = 25, previously diagnosed impaired glucose tolerance.

267 individuals in 31 centres were included in the study, 258 of these were eligable for final analysis. Mean age was 61 ys, mean BMI 30,3, 68% were on antihypertensive treatment. 39% showed IGT, 13% already showed diabetes mellitus type 2 (DM2). Correlation between 20 different parameters and results of OGTT assessment were analysed. Among others parameters recorded were BMI, waist to hip ratio, blood pressure, pulse rate, medical history, fasting glucose, HbA1c, microalbuminuria, hsCRP.

About 50% of individuals included already showed IGT or even had DM2. Age >55 and HbA1c > 6% were highly predictive for a pathological OGTT.

Some clinical parameters that were found to enable risk-assessment of prediabetes were combined in a screening form suitable for routine use by general practitioners. Individual results and the screening form will be presented and discussed.