Undetected Diabetes Research Articles

Prevalence of Diabetes and Impaired Glucose Tolerance in 64-Year-Old Swedish Women

The purpose of this study was to describe the prevalence of diabetes and impaired glucose tolerance (IGT) in middle-aged women and to examine the variability and practical use of the oral glucose tolerance test (OGTT) in the screening for IGT and diabetes. All 64-year-old women living in Göteborg, Sweden, were invited to take part in a screening examination (n = 4,856). Of these, 82% (n = 3,998) responded and 53% (n = 2,595) participated and underwent anthropometric measurements and a 75-g standardized OGTT that was repeated within 2 weeks in those not showing normal glucose tolerance (NGT). The prevalences of known and new diabetes, IGT at both OGTTs, and impaired fasting glucose were 4.7, 4.8, 14.4, and 6.4%, respectively. Half of the women with diabetes were previously undiagnosed, and 37% of the diagnoses were based on OGTT and diabetes 2-h values at both or one of the two examinations. Women with IGT at both OGTTs, in comparison with those with one impaired and one normal OGTT, had higher BMI, waist girth, and blood pressure. More than 40% of the women showed impaired glucose metabolism. Among these women, the prevalence of undetected diabetes was high and repeated OGTTs were needed to identify and not misclassify a considerable proportion of patients. The degree of glucose tolerance impairment and the number of abnormal OGTTs were directly associated with occurrence of components of the metabolic syndrome.

Impaired fasting glucose in hypertensive patients

To determine the prevalence of multiple risk factors for CAD, especially previously undetected IFG and diabetes mellitus, in a sample of treated hypertensive patients. We conducted this cross-sectional study on 108 patients, 50 years and older, with essential hypertension within an urban academic outpatient primary care practice. We obtained blood pressure measurements and laboratory data, including fasting glucose and lipid values from all subjects. We reviewed the outpatient medical record to determine CAD risk factors and current antihypertensive medications. We totaled the number of CAD risk factors to derive a CAD risk score. The mean result of RIA on two timed overnight urine specimens was used to determine the presence of microalbuminuria in patients. To analyze the data, we stratified the entire sample according to the presence or absence of impaired fasting glucose, then used two-tailed unpaired t-tests to compare parameters between the two groups. Pearson's correlation coefficient was calculated to examine the relationship between FBG, UAE, BMI, lipid values, and the CAD risk score. The analysis was adjusted for patient usage of antiproteinuric medications. We detected previously undiagnosed impaired fasting glucose in 13.9% of subjects. HDL score was significantly lower in subjects with IFG. The FBG value directly and strongly correlated with the degree of CAD risk. Impaired fasting glucose (prediabetes) and diabetes mellitus occur with increased frequency in hypertensive patients. IFG and diabetes in hypertension are associated with greater cardiovascular risk.

Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases?

To assess the relation between fasting plasma glucose (FPG) or 2-h plasma glucose (2hPG) and mortality from all causes, cardiovascular disease (CVD), and non-CVD and to determine whether the relationship is graded or threshold. Diabetes Epidemiology: Collaborative Analysis Of Diagnostic Criteria in Europe (DECODE) is a collaborative prospective study of 22 cohorts in Europe with baseline glucose measurements for 29714 subjects aged 30-89 years who were followed-up for 11 years (329050 person-years). Hazard ratio (HR) for death was estimated using Cox regression analysis. High glucose concentrations as well as very low glucose levels were associated with increased risk of death. Compared with an FPG of 4.50-6.09 mmol/l, the multivariate-adjusted HR (95% CI) for FPG <4.50 mmol/l was 1.2 (1.0-1.4) for all-cause, 1.3 (1.0-1.8) for CVD, and 1.1 (0.9-1.4) for non-CVD mortality; the corresponding HRs for diabetes (FPG >or=7.0 mmol/l) were 1.6 (1.4-1.8), 1.6 (1.3-1.9), and 1.6 (1.4-1.9), respectively. For a 2hPG of 3.01-4.50 mmol/l, as compared with a 2hPG of 4.51-5.50 mmol/l, the HRs were 1.1 (1.0-1.2), 1.1 (0.9-1.3), and 1.1 (1.0-1.3), respectively; the corresponding HRs for diabetes (2hPG >or=11.1 mmol/l) were 2.0 (1.7-2.3), 1.9 (1.5-2.4), and 2.1 (1.7-2.5), respectively. The HR for previously undetected diabetes defined by 2hPG was not significantly different from that for known diabetes, which was significantly higher than that for undetected diabetes based on FPG. Subjects with a 2hPG of 10.01-11.09 mmol/l had mortality risks similar to those diabetic subjects defined by an FPG >or=7.0 mmol/l. The relation between mortality and glucose was J shaped rather than showing threshold effect at high glucose levels, except for CVD mortality and 2hPG, where the relation was graded and increasing.

Prevalence of Diabetes in Care Home Residents

To determine the prevalence of known and undetected diabetes diagnosed either by an elevated fasting baseline sample or by a 2-h post-glucose load sample in a group of residents of care homes in an urban-district setting. We completed individual interviews with patients and caregivers in 30 care homes (both residential and nursing homes) in two metropolitan districts of Birmingham, West Midlands, U.K. All care homes were under the supervision of primary care physicians (general practitioners). We carried out 75-g oral glucose tolerance tests (OGTTs) in consenting residents without previous known diabetes. Criteria for diagnosis of diabetes were obtained from the World Health Organization (1998) and the American Diabetes Association (1997). Of 636 residents available for study, 76 residents (12.0%) were known to have diabetes; of the 560 remaining residents, 286 either refused to participate or were deemed too ill or unavailable to undergo testing. Complete data on 274 OGTTs were obtained (median age 83 years, range 45-101). A total of 46 subjects were diagnosed as having diabetes and 94 as having impaired glucose tolerance. Allowing for subjects who refused or were unable to participate, the calculated total prevalence (which includes known and newly detected diabetes) was 26.7% (95% CI 21.9-32.0). The calculated overall prevalence of impaired glucose tolerance was 30.2% (25.2-35.6). In a group of care home residents not known to have diabetes and able to undergo testing, a substantial proportion have undetected diabetes based on a 2-h postglucose load. These residents warrant further study as they may be at higher cardiovascular risk and require an intervention.

Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes.

Diabetes type 1 is associated with an increased risk for infant congenital malformations. It is debated whether this is true also at gestational diabetes. To study occurrence of congenital malformations in infants whose mothers had preexisting or gestational diabetes. A register study covering over 1.2 million Swedish births in 1987-1997 based on the Swedish health registries. We identified from the Medical Birth Registry 3864 infants born of women with preexisting diabetes and 8688 infants born of women with gestational diabetes. Congenital malformations identified in the Medical Birth Registry, the Registry of Congenital Malformations, and the Hospital Discharge Registry. The rates of congenital malformations among these infants was compared with the population rates. At preexisting diabetes, the total malformation rate was 9.5% while the rate at gestational diabetes was similar to the population rate, 5.7%. At preexisting diabetes, certain conditions were more common than expected: orofacial clefts, cardiovascular defects, oesophageal/intestinal atresia, hypospadias, limb reduction defects, spine malformations, and polydactyly. For some of these conditions, an excess was found also for infants whose mothers had gestational diabetes. Infants with multiple malformations were in excess at preexisting diabetes but not at gestational diabetes but the specific type of malformations involved were similar in the two diabetes groups. It is suggested that in the group of gestational diabetes exists a subgroup with an increased risk for a diabetes embryopathy, perhaps due to preexisting but undetected diabetes type 2.

Anwendung eines sensitiven Verfahrens zur Diagnose des Gestationsdiabetes. Metabolische und klinische Ergebnisse

Der unbehandelte (oder unerkannte) Gestationsdiabetes (GD) ist mit einer signifikanten perinatalen Morbidität und Mortalität behaftet. Es gibt jedoch derzeit keine international einheitlichen Richtlinien zur Diagnose des GD. Ziel der vorliegenden Arbeit ist die Evaluierung einer sensitiven diagnostischen Strategie zur Erfassung des GD.

Campaign to promote general population awareness on undetected diabetes and related risk factors in Spain. Efficacy of different information channels

Campaign to promote general population awareness on undetected diabetes and related risk factors in Spain. Efficacy of different information channels

Diabetes risk score: towards earlier detection of Type 2 diabetes in general practice

Background Type 2 diabetes is common, costly and often goes unrecognised for many years. When patients are diagnosed, the majority exhibit associated tissue damage or established cardiovascular risk. Evidence is accumulating that earlier detection and management of diabetes and related metabolic abnormalities may be beneficial. We aimed to develop and evaluate a score based on routinely collected information to identify people at risk of having undetected diabetes. Methods A population-based sample of 1077 people, aged 40 to 64 years, without known diabetes, from a single Cambridgeshire general practice, underwent clinical assessment including an oral glucose tolerance test. In a separate 12-month study, 41 practices in southern England reported clinical details of patients aged 40 to 64 years with newly diagnosed Type 2 diabetes. A notional population was created by random selection and pooling of half of each dataset. Data were entered into a regression model to produce a formula predicting the risk of diabetes. The performance of this risk score in detecting diabetes was tested in an independent, randomly selected, population-based sample. Results Age, gender, body mass index, steroid and antihypertensive medication, family and smoking history contributed to the score. In the test population at 72% specificity, the sensitivity of the score was 77% and likelihood ratio 2.76. The area under the receiver-operating characteristic curve was 80%. Conclusions A simple score, using only data that are routinely collected in general practice, can help identify those at risk of diabetes. This score could contribute to efficient earlier detection through case-finding or targeted screening. Copyright © 2000 John Wiley & Sons, Ltd.

Major stressful life events in relation to prevalence of undetected type 2 diabetes: the Hoorn Study.

To test whether chronic psychological stress is positively associated 1) with the prevalence of type 2 diabetes; 2) with visceral adiposity; and to test whether 3) the relationship between stress and diabetes is mainly mediated by visceral adiposity In a general Caucasian population aged 50-74 years without a history of diabetes (n = 2,262), the number of major stressful life events experienced during the past 5 years was assessed by self-report before the administration of an oral glucose tolerance test. Diabetes was newly diagnosed among 5% of the subjects. The number of stressful events was positively associated with the prevalence of hitherto undetected diabetes. The highest quintile had a 1.6-fold (95% CI 1.0-2.6) increased probability of undetected diabetes compared with the remaining four quintiles (P<0.05 by logistical regression analysis adjusted for age and sex). This increased probability remained significant after additional adjustment for family history of diabetes, heavy alcohol consumption, physical activity, and low level of education. The number of stressful events was weakly positively associated with waist-to-hip ratio (WHR) (men, P<0.01; women, P = 0.05 by multiple regression analysis adjusted for age). The age- and sex-adjusted association between stress and diabetes was only marginally reduced by adding the WHR into the logistical regression model (odds ratio 1.5 [0.9-2.4]; P = 0.08). These cross-sectional findings are partially consistent with Björntorp's theory that stressful life events, which indicate chronic psychological stress, are indeed associated with undetected type 2 diabetes and with visceral adiposity. However, in this white middle-aged population, visceral adiposity does not seem to be the main link between stress and diabetes.

Diabetes mellitus, impaired glucose tolerance, and hyperinsulinemia in an elderly population. The Rotterdam Study.

To estimate the prevalence of glucose intolerance in the elderly, oral glucose tolerance tests were performed as part of the Rotterdam Study, a population-based study in subjects aged 55 years and over. The study population consisted of 2,668 men and 3,950 women. Diabetes mellitus was defined as the use of antidiabetes medication, or a random or post-load serum glucose level of > or = 11.1 mmol/liter. Impaired glucose tolerance was defined as a post-load serum glucose between 7.8 and 11.1 mmol/liter. In men, the frequency of diabetes mellitus ranged from 5.9% in ages < 60 years to 19.8% in ages > 85 years, and in women from 3.8% in ages < 60 years to 18.9% in ages > 85 years; more than half of the subjects with diabetes were newly diagnosed. The prevalence of impaired glucose tolerance ranged from 8.8% and 11.0% in men and women aged < 60 years to 24.3% and 34.7% in men and women aged > 85 years. The prevalence of diabetes mellitus in the total Rotterdam Study population of 7,439 elderly men and women was estimated to be 11.3% (95% confidence interval (CI) 10.5-12.0). Waist/hip ratio, systolic blood pressure, hypertension, and number of cigarettes smoked increased with a worsening of the glucose tolerance from normal, hyperinsulinemia, impaired glucose tolerance to diabetes in both men and women (p < 0.01, adjusted for age). Body mass index was higher in subjects with glucose intolerance, but the frequency of obesity showed a relative decrease with worsening of glucose tolerance. These results show that glucose intolerance, especially impaired glucose tolerance and undetected diabetes mellitus, is common in the elderly. Moreover, not only subjects with diabetes mellitus but also subjects with hyperinsulinemia and impaired glucose tolerance have an increase of cardiovascular risk factors.

Diabetic retinopathy at the time of diagnosis of NIDDM in South Indian subjects

Several studies from the U.K. and the U.S. have shown that retinopathy was present at diagnosis of non-insulin dependent diabetes mellitus (NIDDM) indicating the likelihood of a latent phase of hyperglycaemia for a long period. This study looked for the prevalence of retinopathy at diagnosis of NIDDM in South Indian subjects who have a fairly high prevalence of diabetes and also a high rate of undetected diabetes. One thousand NIDDM subjects with varying duration of diabetes underwent detailed opthalmoscopic examination for retinopathy. It was noted that the prevalence of retinopathy increased linearly with duration of diabetes. Among the 60 newly diagnosed NIDDM, 4 (6.7%) subjects had background diabetic retinopathy. Using a weighted linear regression analysis with percentage of retinopathy in relation to duration, it was estimated that hyperglycaemia could have been present 4.1 years prior to the diagnosis of NIDDM. Although the prevalence of retinopathy at diagnosis in South Indian NIDDM was lower than the other reported values, in view of the high prevalence of diabetes in Indians, a large number of patients would have the risk of microangiopathy even before diagnosis of diabetes is made.

Undetected Diabetes and the Plastic Surgeon

Plastic surgery candidates are generally healthy. Therefore, major postoperative complications are rare. Should they happen, the surgeon should search for possible causes, one of which is undetected diabetes mellitus. Six patients are presented who, based on the individual or family history or the unusual nature of their complications, were suspected of having diabetic tendencies. This experience necessitated our in-depth search into the role of silent or undetected diabetes. This report emphasizes the importance of positive family history of diabetes and the role of glucose tolerance tests on suspected cases. Even with normal glucose tolerance tests, however, some of these patients with a positive family history of diabetes and history of previous infections suffer from deficiencies in the chemotactic immune system. We recommend full discussion of the increased risk of infection and delayed healing with these patients, conservatism during surgical procedures, and prophylactic use of antibiotics perioperatively.

Altered Organization of Antenatal Care in a Rural District

Letters to the EditorAltered Organization of Antenatal Care in a Rural District Jochen Brunner and MD Gunilla Falana-OlenMD Jochen Brunner Department of Obstetrics and Gynecology, King Khaled General Hospital, Al-Majma'ah 11952, Riyadh Region, Saudi Arabia Search for more papers by this author and Gunilla Falana-Olen Department of Obstetrics and Gynecology, King Khaled General Hospital, Al-Majma'ah 11952, Riyadh Region, Saudi Arabia Search for more papers by this author Published Online:1 May 1989https://doi.org/10.5144/0256-4947.1989.314aSectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionTo the Editor. During 1986 the antenatal care in the Al-Majma'ah Region was reorganized,1 and we wish to describe some interesting results of this reorganization.During 1987 no maternal deaths occurred. Some obstetric data are shown in Table 1. The perinatal mortality rate declined from 4.7% in 1986 to 2.5% in 1987. The stillbirth rate was 1.0% in 1987 as compared to 2.2% in 1986; the probable causes of stillbirth are shown in Table 2. The total number of visible major malformations was five cases in 1987 (three were among the stillbirths). The reduction in the stillbirth rate was pronounced among Saudi women (21 stillbirths in 1986 versus nine in 1987), whereas no change was observed in the non-Saudi group. Only two cases of abruptio placentae were seen in 1987. The number of cord complications was unchanged. As in 1986 there was only one case of intrauterine fetal death due to preeclampsia. One case of intrauterine fetal death was caused by infection in 1987. The patient had premature contractions in the 28th week of gestation. She refused admission although there was a history of premature rupture of the membranes. A few days later she came to the hospital with breech presentation and refused operative delivery. The baby died before the delivery. Its birth weight was 1700 g, and histopathologic examination of the placenta showed acute inflammatory changes of the membranes.Table 1. Some obstetric data.Table 1. Some obstetric data.Table 2. Probable causes of stillbirths.Table 2. Probable causes of stillbirths.In this follow-up study the WHO classifications and definitions2 were used so the data were comparable to those reported by Thomassen et al.1 In 1986 Thomassen found a perinatal mortality rate of 4.7%, while a rate of 3% to 4% was thought to be representative for the Kingdom as a whole in 1985.3From December 1986, a systematic training program started for all the doctors and midwives in our region. From the beginning of 1987 we established antenatal clinics in 11 primary health care centers. The percentage of “unbooked” patients declined from 33% in 1986 to 17% in 1987, and more than 80% of the Saudi women and 90% of the non-Saudi women who delivered at our hospital had been to one or more antenatal check-ups in 1987. The number of obstetric ultrasound examinations rose from 1549 in 1986 to 2874 in 1987, and several midwives are now trained to do the screening procedure.As already pointed out by Thomassen et al,1 brucellosis is the most common infection during pregnancy in our region. In 1987, 55 patients with brucellosis were treated, of whom six aborted during the first trimester. There were no stillbirths due to untreated brucellosis.In December 1986, screening for diabetes mellitus in pregnancy was established. In 1987, 37 cases of diabetes were treated compared with five cases in 1986. Since the start of the screening program there has been no case of undetected diabetes in the group of intrauterine fetal deaths, and no perinatal mortality among those treated for diabetes.We believe that a well-organized antenatal organization including screening for diabetes mellitus and brucellosis and under supervision of obstetricians and skilled midwives is the most effective and least expensive tool in the struggle for lowering the stillbirth rate and perinatal mortality in rural districts of Saudi Arabia.ARTICLE REFERENCES:1. Thomassen PA, Langemark L, Kumar R. "Stillbirths andantenatal care at a general hospital" . Ann Saudi Med. 1989; 9(2):186–9. Google Scholar2. Chiswick ML. "Commentary on current World Health Organization definitions used in perinatal statistics" . Br J Obstet Gynaecol. 1986; 93:1236–8. Google Scholar3. Ohlsson A. "Better perinatal care in Saudi Arabia" . Ann Saudi Med. 1985; 5(3):169–78. Google Scholar Previous article Next article FiguresReferencesRelatedDetails Volume 9, Issue 3May 1989 Metrics History Published online1 May 1989 InformationCopyright © 1989, Annals of Saudi MedicinePDF download

Juvenile periodontitis (periodontosis) in a Nigerian teaching hospital.

A STUDY OF the pattern of juvenile periodontitis (periodontosis) as observed in the University College Hospital, Ibadan was carried out, through a period of one year. The age group was only confined from 14-25 years, and the patients selected for the study were only those patients in the above age group reporting to the Hospi tal's Dental Centre, immaterial of what the patients' main complaint was. It was revealed that there was a high rate of patients attending this Institution with juvenile periodontitis. Further it is quite alarming to note that all the patients examined on their first visits had a clinically observable and detactable chronic gingivitis, some even transitioned to a chronic periodontitis. Routine investigations further revealed a few cases of undetected diabetes and one case of Papillon-Lefevre Syndrome (hyperkeratosis palmoplantaris).

Casual blood glucose levels and prevalence of undiscovered diabetes mellitus in Lagos Metropolis Nigerians

A diabetic screening exercise involving 1627 subjects (1050 males and 577 females) was carried out in the Lagos Metropolis of Nigeria. Casual capillary blood glucose and/or urine glucose were tested for by means of dipsticks. The prevalence rates of undetected diabetes in the males and females were respectively 1.5% and 1.9%. Mean (+/- SD) casual blood glucose levels were higher in the females (82.8 (+/- 19.1) mg/100 ml) than in the males (75.9 (+/- 16.2) mg/100 ml). The prevalence of renal glycosuria was 1.3% in the males and 0.2% in the females. The prevalence of diabetes mellitus in the Lagos Metropolis appears high but similar to that in many other countries. The ambient blood glucose in the non-hospitalized subjects also seems to be not significantly different from values reported in other places.

Cost efficacy of routine screening for diabetes in pregnancy: 1-h versus 2-h specimen.

Undetected gestational diabetes mellitus (GDM) is associated with a two- to fivefold increase in perinatal morbidity and mortality. Widespread screening of the obstetric population (resulting in identification and treatment) should reduce these rates. Seven hundred ninety-eight women were examined during a 13-mo period of universal glucose challenge testing (GCT). A total of 2.8% of the population had an abnormal oral glucose tolerance test (OGTT). Thirty percent of those with an abnormal OGTT were less than 25 yr old. The specificity of a 1-h GCT (50-g carbohydrate load) using a threshold of either 140 or 150 mg/dl was compared with that of a 2-h specimen using a threshold of 118 mg/dl to determine whether the cost of screening could be reduced. One- and 2-h specimens were obtained in 347 of these women. A 34% reduction in the number of follow-up OGTTs required would have been achieved if a 2-h specimen had been used as the index instead of a 1-h specimen (P less than .05). As a result, the (direct and indirect) cost per patient identified with GDM would have declined 23.5%--from $866 to $662. No comment concerning the actual false-negative rate of either the 1- or 2-h GCT can be made because only select women underwent an OGTT. To assess the validity of the 2-h threshold, an OGTT was performed in an additional 190 women if either the 1- or 2-h screen was abnormal. The results were confirmatory: the 2-h screen would have reduced the cost per case identified by 32% in this small group. Screening on the basis of past medical history clearly lacked sensitivity and cost efficacy in comparison with the GCT and should be abandoned as a practice.

Total glycosylated hemoglobin in mothers of large-for-gestational-age infants: a postpartum test for undetected maternal diabetes?

Total glycosylated hemoglobin has been evaluated postpartum using a colorimetric (thiobarbituric acid: TBA) method in 50 mothers of large-for-gestational-age (LGA) infants (greater than 90th percentile by weight). 30 women without potential risk factors for chemical diabetes who gave birth to appropriate-for-gestational-age (AGA) infants formed the control group. When compared to the control mothers, mean total glycosylated hemoglobin (TBA color) levels were significantly higher in the mothers of LGA infants (p less than 0.01). 4 of the latter had an abnormal oral glucose tolerance test (GTT) done within 5 days postpartum and significantly elevated glycosylated hemoglobin compared to mothers of LGA infants with normal GTT (p less than 0.001). Furthermore, a significant linear correlation was found for mothers of LGA infants between TBA color levels and each of the following: fasting serum glucose (p less than 0.001), 1-hour serum glucose (p less than 0.001), 2-hour serum glucose (p less than 0.001), and infant birth weight (p less than 0.05). Analysis of TBA color levels early postpartum might be an alternative method for detecting unsuspected chemical diabetes in pregnancy.

Papular Granuloma Annulare and Diabetes Mellitus

Three patients with widespread papular granuloma annulare lesions and previously undetected diabetes mellitus are described. A peculiar clinical feature included serpiginous papules on the dorsa of the hands along with typical granuloma annulare lesions. Utilizing a standard glucose tolerance or cortisone glycosuria tests defined the underlying diabetic state.

Analysis of tests for diabetes in 250,000 persons screened for diabetes using finger blood after a carbohydrate load.

The results of a detection program for diabetes over a four-year period, using a finger blood test after a carbohydrate load, were analyzed. After excluding persons with known diabetes or incomplete data, 250,938 had the initial screening test and 9,682 or 3.9 per cent screened “positive.” Approximately 75 per cent of the “positive” screenees returned for a confirmatory carbohydrate tolerance test. Five thousand, three hundred and seventy persons, or approximately 74 per cent of those who returned, had “positive” confirmatory tests. Since only persons who were “positive” in both tests were considered to have diabetes, the prevalence rate for previously undetected diabetes was 2.1 per cent. When allowance was made for “positive” screenees who failed to return by assuming that they would confirm “positive” at the same rate as the returnees, the estimated prevalence rate for previously undetected diabetes was 2.8 per cent. A representative sample of 100,077 persons showed very similar test results which were further analyzed by sex, race, weight and family history in relation to decades of age. The prevalence rate of undetected diabetes and the rate of “positive” confirmation for “positive” screenees varied markedly with age. The importance of considering the other variables in relation to age for planning detection programs is discussed; 60 per cent of the persons with diabetes detected in this program had a negative family history for diabetes. Information from return postcards sent to “positive” screenees from three months to three years after their initial test showed that a very high percentage of screenees had consulted their physicians as a result of the test; 62 per cent of the confirmed “positives” who replied stated that the diagnosis of diabetes had been confirmed by their physicians.

Unknown diabetes mellitus among apparently healthy men with "nonspecific" T wave abnormalities--in a mental hospital.

A group of 117 psychiatric male inpatients under age fifty, physically healthy, without known diabetes or manifest heart disease or electrocardiographic evidence of myo-cardial infarction, were given a 100-gm., two-hour oral glucose tolerance test because their electrocardiograms showed inverted or isoelectric T waves. These men were compared with a similarly studied control group of 303 who did not have such nonspecific abnormalities. Significantly more diabetes was discovered in the former group among those aged forty to forty-nine. At that age, then, abnormal T waves were significantly associated with previously unknown diabetes. Results suggest there is an unusually high prevalence of undetected diabetes among apparently healthy men in their forties who have these nonspecific T wave abnormalities.