Screening Test For Diabetes Mellitus Research Articles

Serum fructosamine as a screening test for diabetes mellitus in non-healthy middle-aged to older dogs.

Diabetes mellitus is a common endocrine disorder among non-healthy middle-aged to older dogs. Previous studies have shown that serum fructosamine can be used to detect the chronic unregulated hyperglycaemia in Diabetes mellitus. The present study was therefore conducted to assess the value of serum fructosamine as a screening test for Diabetes mellitus among non-healthy middle-aged to older dogs in terms of sensitivity, specificity, positive and negative predictive values. A total of 99 non-healthy dogs (16 dogs with Diabetes mellitus and 83 dogs with other diseases) with an age ranging from 6 to 15 years were included in the study. Using the upper reference limit for serum fructosamine (343.8 mumol/l), sensitivity and specificity were 0.88 and 0.99, respectively and assuming the prevalence of Diabetes mellitus to be 0.05, the positive and negative predictive values were 0.82 and 0.99, respectively. Apparently, serum fructosamine could also be used to distinguish hyperglycaemia non-diabetic dogs from hyperglycaemic diabetic dogs. Thus, the present study showed that serum fructosamine is a reliable screening test for Diabetes mellitus among non-healthy middle-aged to older dogs.

Random blood glucose estimations on admission as a screening test for diabetes in an elderly population

AbstractThe prevalence of diabetes mellitus increases with advancing age but often remains undiagnosed. We examined the use of a blood glucose assay, performed on admission in 515 consecutive acute admissions, aged 65 years and over as an initial screening test for diabetes mellitus. Of these, 7.6% were previously known to have diabetes and 4.7% were newly diagnosed on the basis of subsequent fasting blood glucose estimations. Using a random blood glucose level ≥8.0mmol/1, 18.5% of those screened needed further investigation. Although this method has been used for many years to screen for diabetes a formal comparison with a glucose tolerance test is needed before it can be used as the sole screening test.

Fructosamine as a screening test for diabetes mellitus

AbstractThe effectiveness of serum fructosamine as a screening test for diabetes mellitus was assessed by comparison with the response to a 75g oral glucose tolerance test (OGTT) in 114 non‐pregnant and 36 pregnant individuals. The mean fructosamine level was higher in diabetic than in normal subjects whereas the mean in subjects with impaired glucose tolerance was not significantly different from that of normal controls. In predicting an abnormal response to OGTT, the sensitivity of fructosamine was only 35%. Pregnant subjects had a lower mean fructosamine than normal; none of nine subjects with gestational diabetes had an elevated level. We conclude that fructosamine has no place as a diagnostic screening test for diabetes in pregnancy.

空腹時血糖と新フルクトサミンの組合せによる耐糖能スクリーニングの検討

空腹時血糖と新フルクトサミンの組合せによる耐糖能スクリーニングの検討

Clinical significance of measuring glycated fibrinogen in plasma in diabetes mellitus

The clinical significance of measuring glycated fibrinogen (G Fbg) in plasma was studied using a simple, rapid method for determining plasma G Fbg developed by the authors. This method is based on modified fibrin clot formation for purification of plasma Fbg, and G Fbg was estimated by improved colorimetric fructosamine assay. The values of plasma G Fbg were expressed as glycated polylysine equivalents (mumol/l). In this clinical study, 106 examinees who underwent a screening test for diabetes mellitus (DM) because of glycosuria or hyperglycemia were investigated. According to the WHO diagnostic criteria, they were divided into 3 groups: non DM group (n = 35), impaired glucose tolerance (IGT) group (n = 31) and DM (non-treated) group (n = 40). In addition, healthy controls (n = 40) and treated diabetic patients (DM treated) were involved. Plasma G Fbg/Fbg, fasting plasma glucose (FPG), fructosamine and glycated hemoglobin (HbA1c) were also analyzed in subjects of the 5 groups. Non-treated DM patients showed high levels of plasma G Fbg, which were significantly higher than those of any other groups. G Fbg levels in IGT group were significantly higher than those in healthy controls or the non-DM group. Together with a significant positive correlation between G Fbg and FPG, these results indicate that the levels of plasma G Fbg depend on plasma glucose levels.(ABSTRACT TRUNCATED AT 250 WORDS)

第19回日本総合健診医学会学術大会講演抄録集 新フルクトサミンと空腹時血糖による糖尿病スクリーニングの有用性

第19回日本総合健診医学会学術大会講演抄録集 新フルクトサミンと空腹時血糖による糖尿病スクリーニングの有用性

The abbreviated glucose tolerance test in screening for diabetes: the Islington Diabetes Survey.

The World Health Organization has recommended a single 2-h post-glucose load blood glucose level as a screening test for diabetes mellitus in epidemiological surveys. We have assessed its characteristics, when compared with a full supervised glucose tolerance test (OGTT), in estimating prevalence, and in diagnosing diabetes in the individual patient. A stratified sample of 223 of 1040 subjects who had participated in a diabetic survey that utilized a single capillary 2-h blood glucose estimation as a screening test were recalled for formal glucose tolerance testing. The numbers of subjects with diabetes at screening and at recall were similar (14/212, 6.6%; 13/216, 6.0%) but only 9 subjects were so classified on both occasions. Thirty-five subjects (16.5%) were suspected of having impaired glucose tolerance (IGT) at screening, and 52 (24.1%) at recall. There was substantial reclassification from screening IGT, with 3/35 worsening to diabetes, and 10/35 returning to normal. Capillary 2-h glucose levels gave an accurate assessment of the prevalence of diabetes but underestimated that of IGT. On the full OGTT, little difference in classification was found when the values of fasting and 1-h blood glucose were used in addition to those of the 2-h blood glucose used alone. The 2-h glucose had a within-subject coefficient of variation of 32.4% which produced substantial reclassification of subjects with levels close to the diagnostic levels for diabetes, and this implies that such individuals should not be classified as having diabetes on the basis of a single glucose tolerance test.(ABSTRACT TRUNCATED AT 250 WORDS)

Four assay methods for glycated hemoglobin compared as screening tests for diabetes mellitus: the Islington Diabetes Survey.

We assessed the utility of four methods of glycated hemoglobin assay (agar gel electrophoresis with Schiff base, agar gel electrophoresis with prior removal of Schiff base, boronate affinity chromatography, and isoelectric focusing) as screening tests for diabetes mellitus, studying 223 subjects undergoing an oral glucose-tolerance test after fasting and 2 h after ingestion of 75 g of glucose. Assessment of glucose tolerance status according to the 1980 World Health Organization diagnostic criteria indicated that 13 subjects (5.8%) had diabetes, 48 (21.5%) had impaired glucose tolerance, and nine (4.0%) could not be classified (six of these because of missing values). Use of receiver-operating characteristic curves to compare the assays as screening tests showed the affinity chromatography assay to be superior. Assays for glycated hemoglobin after fasting had better precision than post-glucose-load assays as screening tests, and test characteristics of glycated hemoglobin assays on fasting subjects were similar to those of the blood-glucose estimation after fasting. We conclude that measurement of glycated hemoglobin may be a useful screening test for diabetes, and that such measurement of stable glycated hemoglobin is as accurate as measurement of fasting blood-glucose in screening for diabetes. For this use, we found methods that measure stable glycated hemoglobin superior to that measuring both stable and labile Schiff-base fractions.

第16回日本総合健診医学会学術大会講演抄録 半日ドックにおける糖尿病検診の在り方

第16回日本総合健診医学会学術大会講演抄録 半日ドックにおける糖尿病検診の在り方

Glycosylated hemoglobin as an index of the prevalence and severity of diabetes in biethnic Fiji

Glycosylated hemoglobin was compared with fasting blood glucose as a screening test for diabetes mellitus and as an index of the severity of diabetes in biethnic (Melanesian and Indian) Fiji. Age-adjusted diabetes prevalence in the test sample was higher in Indians by either criterion. According to the hemoglobin A1 criterion, Melanesians had prevalence rates of 8.2% (males) and 15.8% (females) compared to 17.0% (males) and 24.3% (females) in Indians. In contrast, fasting blood glucose criteria (WHO) gave higher rates in each group. Hemoglobin A1 levels were higher overall in Indians and females. The predictive value of an elevated fasting blood glucose test for an elevated hemoglobin A1 was 20.0% in Melanesians and 60.7% in Indians while that of a normal fasting blood glucose test for a normal hemoglobin A1 was 89.4% in Melanesians and 89.3% in Indians. The proportion of Indians with elevated hemoglobin A1 who were severely hyperglycemic was almost 7 times higher (40.9% vs. 5.8%) than that of Melanesians. The ethnic difference in the predictive value of fasting blood glucose levels for hemoglobin A1 levels appears to be related to the greater severity of hyperglycemia of diabetic Indians compared to diabetic Melanesians. Hemoglobin A1 levels provide information on both the qualitative as well as quantitative differences in diabetes between ethnic groups.

Evaluation of three potential screening tests for diabetes mellitus in a biethnic population.

We tested the ability of three potential screening tests for diabetes (fasting plasma glucose value greater than or equal to 140 mg/dl, 1-h postglucose (PG) load value greater than or equal to 200 mg/dl, and 2-h PG value greater than or equal to 200 mg/dl) to detect non-insulin-dependent diabetes in 130 diabetic Mexican Americans (MAs) and 50 diabetic Anglo Americans (AA) using the National Diabetes Data Group criteria as the standard. The sensitivity of the fasting plasma glucose (FPG) cutpoint in detecting diabetes was low in both AAs (36.0%) and MAs (59.3%) and was related to the age-adjusted prevalence rates of diabetes in the two ethnic groups (AAs, 4.9%; MAs, 10.9%). The 2-h PG load cutpoint had good sensitivity (greater than 93%) and specificity (greater than 99%) in both ethnic groups. The ethnic difference in the sensitivity of the FPG cutpoint appeared to be related to the greater hyperglycemia of diabetic MAs compared with diabetic AAs. Nearly 30% of diabetic MAs had FPG values greater than or equal to 200 mg/dl as contrasted with only 10% of diabetic AAs. The difference in severity of hyperglycemia between the ethnic groups appears to be unrelated to ethnic differences in adiposity, pharmacologic treatment, or delay in diagnosis, although longer disease duration in MAs may explain part of the difference.

Glycosylated hemoglobin: A screening test for diabetes mellitus?

Glycosylated hemoglobin (GHb), or HbA, is now a popular test in the management of Insulin Dependent Diabetes (IDDM) as it provides an integrated measure of blood glucose concentrations over the preceding 1–3 months. In this report we evaluate its potential as an epidemiologic screening tool through its relationship to the standard diagnostic test—an Oral Glucose Tolerance Test (OGTT). Using data from over 400 relatives of IDDM patients, thought to be free of diabetes, we demonstrate that there was a significant correlation between GHb and glucose concentrations during an OGTT (maximum correlation, r = 0.27, P < 0.001). This was largely limited to adults. However, only 37% of the relatives who were found to have a diabetic OGTT also had a GHb above the normal range (mean ± 2 SD). Furthermore, only 25% of those with either diabetes or impaired glucose tolerance had an abnormal GHb. We thus conclude that GHb is too insensitive a measure to be used as a screening tool for the detection of diabetes mellitus as currently defined.

The efficiency of screening tests for diabetes

in the group being screened ; (2) the reliability of the screening test; and (3) the efficiency of the test. Reliability here refers to the extent to which the results of the test may be reproduced by a laboratory technician of average training. Deficiency (validity) here refers to the frequency of confirmation of the test by accepted diagnostic procedure at a given level of reliability. This paper will be limited to the quantification of the efficiency of screening tests for diabetes mellitus as case-finding procedures. From 1954 through 1957, a study was made by the Public Health Service, United States Department of Health, Education, and Welfare, at the Outpatient Department of Boston City Hospital, Boston, Massachusetts. The purpose of the investigation was to determine the efficiency of a number of blood and urine screening tests under timed and controlled conditions of food intake. This study was a further development of an earlier study reported by Kurlander, Iskrant, and Kent,’ which was based on 273 persons screened under less closely controlled circumstances. Preliminary reports on the present study have appeared in two published summaries.2*3 The efficiency of a screening test-previously defined as the frequency of confirmation by accepted diagnostic procedure-is measured in terms of sensitivity and specificity. Sensitivity is defined as the ability of the test to classify as positive those who have the condition or disease being screened for in an apparently well population. It is expressed as the percentage screening positive of the total true previously unknown cases of the disease. Speci$city is defined as the ability of the test to classify as negative those who do not have the condition