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Diabetologia
Published in: Diabetologia 9/2011

01-09-2011 | Article

Screening for diabetes using an oral glucose tolerance test within a western multi-ethnic population identifies modifiable cardiovascular risk: the ADDITION-Leicester study

Authors: D. R. Webb, L. J. Gray, K. Khunti, B. Srinivasan, N. Taub, S. Campbell, J. Barnett, A. Farooqi, J. B. Echouffo-Tcheugui, S. J. Griffin, N. J. Wareham, M. J. Davies

Published in: Diabetologia | Issue 9/2011

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Abstract

Aims/hypothesis

The aim of this study was to determine the frequency of undiagnosed glucose abnormalities and the burden of cardiovascular disease (CVD) risk among south Asians and white Europeans attending a systematic screening programme for type 2 diabetes (ADDITION-Leicester) and to estimate the achievable risk reduction in individuals identified with glucose disorders.

Methods

Random samples of individuals (n = 66,320) from 20 general practices were invited for a 75 g OGTT and CVD risk assessment. Ten-year CVD risk among screen-detected people with diabetes or impaired glucose regulation (IGR) (impaired fasting glycaemia and/or impaired glucose tolerance [IGT]) was computed using the Framingham-based ETHRISK engine and achievable risk reduction was predicted using relative reductions for treatments extracted from published trials.

Results

A total of 6,041 participants (48% male, 22% south Asian) aged 40–75 years inclusive were included. Undiagnosed glucose disorders occurred more frequently in south Asians than white Europeans; age and sex adjusted odds ratios were 1.74 (95% CI 1.42–2.13) and 2.30 (95% CI 1.68–3.16) for IGT and diabetes respectively. Prevalence of any undetected glucose disorder was 17.5% in the whole cohort. Adjusted 10-year risk was similar in screen-detected people with IGR and diabetes (18.3% vs 21.6%), and was higher in south Asians across the glucose spectrum. Absolute CVD risk reductions of up to 13% in those with screen-detected type 2 diabetes and 6% in IGR are achievable using existing cardioprotective therapies.

Conclusions/interpretation

Population screening with an OGTT identifies a significant burden of modifiable CVD risk, especially within south Asian groups. Strategies enticing this population to consider screening programmes are urgently needed as significant risk reduction is possible once a glucose abnormality is identified.

Trial registration:

ClinicalTrials.gov NCT00318032

Funding:

The project is funded for support and treatment costs by NHS Department of Health Support for Science and project grants.
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Metadata
Title
Screening for diabetes using an oral glucose tolerance test within a western multi-ethnic population identifies modifiable cardiovascular risk: the ADDITION-Leicester study
Authors
D. R. Webb
L. J. Gray
K. Khunti
B. Srinivasan
N. Taub
S. Campbell
J. Barnett
A. Farooqi
J. B. Echouffo-Tcheugui
S. J. Griffin
N. J. Wareham
M. J. Davies
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 9/2011
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2189-2

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