Results of screening risk of diabetes mellitus type 2 in Voronezh residents

• O.V. Logvinova

Abstract

Introduction. Increase in the incidence of diabetes mellitus (DM) and more rapid increase in the number of people with a condition called pre-diabetes, determine the need for a paradigm shift: the transition from diabetes diagnosis, treatment based on a physician if complaints about already existing DM to work to proactively identify individuals at high risk for its development and implementation of appropriate preventive measures among them.

Purpose. Assess the degree of risk of developing diabetes mellitus type 2 among residents of Voronezh in the next 10 years. Achieving this goal would involve the following tasks: to identify groups at risk of this disease in the next 10 years; to identify the most significant factors in high-risk groups, to determine complex of preventive measures to reduce the risk of diabetes mellitus type 2.

Materials and methods. Material for the study is based on a screening of the adult population of the city of Voronezh, held in the framework of «Tell diabetes ‘No!’». Venue – emergency hospital number 10. The screening was attended by everyone, regardless of gender, presence or absence of concomitant somatic pathology. The study included all persons screened; resulting in a representative sample was formed of 290 people: 210 women and 80 men. None of the subjects had previously laden with the diagnosis of «diabetes». Screening was based on a questionnaire http://www.idf.org/diabetes-prevention/questionnaire counting scales FINDRISK. Data processing and analysis were carried out with the help of computer programs Excel 2013 (Microsoft) and Statistica 6.0. Type distribution of the sample was evaluated using the Kol mogorov-Smirnov test, the studied parameters were given as M±m. Methods that were used: the collection of anamnestic data, evaluation of physical status (height, weight, BMI, waist circumference, blood pressure), measurement of blood glucose (blood glucose meter).

Results. By evaluating the presence and severity of risk factors identified: 44,1% of screened have a low, 13,2% – moderate, 42,7% – higher risk of developing diabetes mellitus type 2. Presumably the examinees with high risk already have diabetes mellitus type 2, possibly with the presence of its late complications. In most cases, the examinees with a high risk of developing diabetes mellitus type 2 did not anticipate at the presence of the disease, and had never applied to the endocrinologist. The study analyzed the risk factors and their ranking by frequency of occurrence. That was founded that in the group with a high risk visceral obesity is prevailing on the prevalence (incidence - 98.4% screened). The second most common age factor should be – in 94% of cases. That is followed by hypertension and antihypertensive therapy drug in history – 80%, by overweight and obesity in 75%.

In the group with a low risk of developing diabetes mellitus type 2 incidence of the studied parameters were: visceral obesity – 39%, age over 45 years – 53,1%, drug antihypertensive therapy in history – 23,4%, obesity – 18,8%.

The next in rank importance placed lack of regular physical activity – in 74% of cases, genetic predisposition – almost 69%. The least significant in the group turned the wrong food – in 42% of cases. Fig. 2 shows the frequency of occurrence of these factors in each of the risk groups.

Conclusions. More than 40% of the Voronezh residents have a high risk of developing type 2 diabetes mellitus. At the same time most of the important risk factors are modifiable and amenable to correction by means of preventive measures, as which include:

– public awareness about diabetes, its complications and the role of early detection of disorders of carbohydrate metabolism;

– definition of the target population (high-risk of developing type 2 diabetes) by introducing the questionnaire FINDRISK in the work of general practitioners and internists in Voronezh;

– verification of metabolic disorders in high-risk group;

– correction of modifiable risk factors (hypertension, obesity, physical inactivity, poor nutrition);

Keywords:diabetes mellitus type 2, screening, risk factors, impaired fasting glucose, impaired glucose tolerance, prevention

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