Effect of screening for Type 2 diabetes on population-level self-rated health outcomes and measures of cardiovascular risk: 13-year follow-up of the Ely cohort.
Bottom Line: There is continuing uncertainty regarding the overall net benefits of population-based screening for Type 2 diabetes.Thirteen years after the commencement of screening, self-rated functional health status and health utility were identical between the screened and unscreened populations.Clinical measures, self-reported medication and cardiovascular morbidity were similar between the two groups.
Affiliation: General Practice and Primary Care Research Unit, University of Cambridge, Cambridge, UK.Show MeSH
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Mentions: The Ely Study (Cambridgeshire, UK) was established in 1990 as a prospective study of the aetiology of Type 2 diabetes. Full details of the population are reported elsewhere . In brief, a third (n = 1705) of all men and women aged 40–65 years were randomly selected from a sampling frame of adults free of known diabetes registered with a single practice serving Ely (n = 4936). Housebound individuals were excluded prior to invitation. These individuals were invited between 1990 and 1992 for screening for Type 2 diabetes using a 75-g oral glucose tolerance test and related cardiovascular disease risk factors (the screened population). Further follow-up of this group occurred at a median of 4.5 years (1994–1996) and 10 years (2000–2003), including invitation to non-attenders at baseline (Fig. 1). At each screening round, general practitioners were informed by letter of participants’ fasting plasma cholesterol and triacylglycerol values, blood pressure and the results of the oral glucose tolerance test. Among the remaining two-thirds of the sampling frame who were still alive in 2000–2003, 1577 individuals were randomly selected for invitation to a health assessment, including an oral glucose tolerance test (the unscreened population). No standard intervention package was specified for people found to have Type 2 diabetes or elevated cardiovascular disease risk factors following screening. General practitioners were informed of the results and advised to take whatever action they thought necessary. The Ely study was approved by the Cambridge Local Research Ethics Committee (99/246). All participants gave written informed consent.
Affiliation: General Practice and Primary Care Research Unit, University of Cambridge, Cambridge, UK.