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Prediabetes Screening Questionnaire

A Novel Testing Model For Opportunistic Screening Of Pre-diabetes And Diabetes Among U.s. Adults

A Novel Testing Model For Opportunistic Screening Of Pre-diabetes And Diabetes Among U.s. Adults

A Novel Testing Model for Opportunistic Screening of Pre-Diabetes and Diabetes among U.S. Adults Affiliation The First Affiliated Hospital of Medical School, Xian Jiaotong University, Xian, Shaanxi, China Affiliation Pennington Biomedical Research Center, Baton Rouge, LA, United States of America Affiliation Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, United States of America Affiliation Department of Public Health Sciences, Clemson University, Clemson, SC, United States of America Affiliation Department of Public Health Sciences, Clemson University, Clemson, SC, United States of America A Novel Testing Model for Opportunistic Screening of Pre-Diabetes and Diabetes among U.S. Adults The study aim was to evaluate the performance of a novel simultaneous testing model, based on the Finnish Diabetes Risk Score (FINDRISC) and HbA1c, in detecting undiagnosed diabetes and pre-diabetes in Americans. This cross-sectional analysis included 3,886 men and women ( 20 years) without known diabetes from the U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2010. The FINDRISC was developed based on eight variables (age, BMI, waist circumference, use of antihypertensive drug, history of high blood glucose, family history of diabetes, daily physical activity and fruit & vegetable intake). The sensitivity, specificity, and the receiver operating characteristic (ROC) curve of the testing model were calculated for undiagnosed diabetes and pre-diabetes, determined by oral glucose tolerance test (OGTT). The prevalence of undiagnosed diabetes was 7.0% and 43.1% for pre-diabetes (27.7% for isolated impaired fasting glucose (IFG), 5.1% for impaired glucose tolerance (IGT), and 10.3% for having both IFG and Continue reading >>

Screening And Monitoring Of Prediabetes

Screening And Monitoring Of Prediabetes

Screening for Prediabetes AACE recommends that individuals who meet any of the clinical risk criteria noted below should be screened for prediabetes or type 2 diabetes (T2D) (1). Age ≥45 years without other risk factors CVD or family history of T2D Overweight or obese Sedentary lifestyle Member of an at-risk racial or ethnic group: Asian African American Hispanic Native American (Alaska Natives and American Indians) Pacific Islander High-density lipoprotein cholesterol (HDL-C) <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L) Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and/or metabolic syndrome Polycystic ovary syndrome (PCOS), acanthosis nigricans, or nonalcoholic fatty liver disease (NAFLD) Hypertension (blood pressure >140/90 mm Hg or on antihypertensive therapy) History of gestational diabetes or delivery of a baby weighing more than 4 kg (9 lb) Antipsychotic therapy for schizophrenia and/or severe bipolar disease Chronic glucocorticoid exposure Sleep disorders in the presence of glucose intolerance (A1C >5.7%, IGT, or IFG on previous testing), including obstructive sleep apnea (OSA), chronic sleep deprivation, and night-shift occupation In the event of normal results, repeat testing at least every 3 years. Clinicians may consider annual screening for patients with 2 or more risk factors (1). Medications and Prediabetes Risk Specific medications that increase prediabetes risk include: Antidepressants: The ongoing use of antidepressant medications may modestly increase the risk of developing prediabetes or T2D, although the elevation in absolute risk is modest (2). Psychotropic agents: Certain treatments for schizophrenia or bipolar disease may increase prediabetes, T2D, and/or CVD risk. Substantial weight gain has b Continue reading >>

Development Of The Canrisk Questionnaire To Screen For Prediabetes And Undiagnosed Type 2 Diabetes - Sciencedirect

Development Of The Canrisk Questionnaire To Screen For Prediabetes And Undiagnosed Type 2 Diabetes - Sciencedirect

Development of the CANRISK questionnaire to screen for prediabetes and undiagnosed type 2 diabetes Author links open overlay panel JanuszKaczorowskiMA PhD1 Get rights and content The prevalence of type 2 diabetes in Canada and worldwide has risen more quickly during the last 2 decades than originally forecast. Since 2005, the Public Health Agency of Canada (PHAC) has consulted with leading Canadian and international experts to develop and evaluate a strategy to address the pending diabetes epidemic. Emphasis has been placed on the prevention of type 2 diabetes among high-risk groups with impaired fasting glucose and/or impaired glucose tolerance (also referred to as prediabetes) as growing evidence demonstrates that type 2 diabetes can be prevented or delayed through lifestyle or pharmacological interventions. Before such preventive interventions can be widely applied in Canada, however, practical early detection strategies must be successfully implemented and evaluated. PHAC is developing a "made-in-Canada," non laboratory-based screening questionnaire, validated against the diagnostic gold standard, to identify prediabetes and undiagnosed diabetes among middle-aged adults. This 2-stage screening approach is based on an effective Finnish model (the Finnish Diabetes Risk Score [FINDRISC]), which is being adapted to reflect Canada's multi-ethnic population. Seven provincial pilots are currently underway to field test and validate this screening approach, while also assessing effectiveness and user satisfaction. This new implementation research will help inform Canadian efforts aimed at preventing type 2 diabetes. La prvalence du diabte de type 2 au Canada et dans le monde a augment plus rapidement que prvu au cours des vingt dernires annes. L'Agence de la sant publique Continue reading >>

Hba1c As A Marker Of Prediabetes: A Reliable Screening Tool Or Not

Hba1c As A Marker Of Prediabetes: A Reliable Screening Tool Or Not

Review Article - Insights in Nutrition and Metabolism (2017) Volume 1, Issue 1 1Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, NZ 2Department of Medicine, University of Auckland, Auckland, NZ *Corresponding Author: Sally D Poppitt School of Biological Sciences and Department of Medicine University of Auckland, Private Bag 92019, Auckland New Zealand Tel: +64 [09] 630 5160 E-mail: [email protected] Citation: Sequeira IR, Poppitt SD. HbA1c as a marker of prediabetes: A reliable screening tool or not? Insights Nutr Metabol 2017;1(1):11-20. Copyright: ©2017 Sequeira IR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Increasing global prevalence of type 2 diabetes (T2D) has resulted in concerted efforts to improve predictors for development of this obesity-related disorder. Establishing markers that identify prediabetes, an intermediary state of glycaemia above that of healthy individuals but below frank T2D, is an important focus. International cut offs have long been based on the 2 h WHO-defined oral glucose tolerance test (OGTT), but more recent use of the quicker and cheaper marker of glycated haemoglobin (HbA1c) has become widespread in clinical practice and public health. The definition of people with prediabetes in turn has expanded from those with impaired glucose tolerance (IGT) to include individuals with impaired fasting glucose (IFG) and/or raised HbA1c. Whilst HbA1c has been recommended since 2010 for both T2D and prediabetes screening, concerns have been raised over validity particularly for identifying those who Continue reading >>

Assessment Tool Helps Screen Patients For Prediabetes

Assessment Tool Helps Screen Patients For Prediabetes

Home / Conditions / Prediabetes / Assessment Tool Helps Screen Patients for Prediabetes Assessment Tool Helps Screen Patients for Prediabetes An assessment tool known as Tool to Assess Likelihood of Fasting Glucose ImpairmenT (TAG-IT) is effective in screening patients of varying ethnic backgrounds for prediabetes, according to the results of a new study. Researchers say the test is an improvement over using BMI alone or using a list of risk factors. "Fifty-four million people in the United States have impaired fasting glucose (IFG); if it is identified, they may benefit from prevention strategies that can minimize progression to diabetes, morbidity, and mortality," write Richelle J. Koopman, MD, MS, from the University of Missouri in Columbia, and colleagues. "We created a tool to identify those likely to have undetected hyperglycemia.We then validated TAG-IT in a second population-based sample, and compared TAG-IT with BMI [body mass index] alone for the ability to predict IFG and undiagnosed diabetes." Using existing data from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2004, this cross-sectional analysis examined 4045 US adults aged 20 to 64 years who were not diagnosed with diabetes but who had a fasting plasma glucose measurement. The investigators developed a logistic regression model predicting IFG and undiagnosed diabetes from characteristics that are self-reported or measured without laboratory testing. On the basis of this model, TAG-IT was developed, validated with use of NHANES III, and compared with BMI alone. Subsets based on race and ethnicity were also examined. Factors that were most predictive of IFG and included in the final version of TAG-IT were age, sex, BMI, family history of diabetes, resting heart rate, and history of Continue reading >>

Is Web-based Test For Prediabetes Faulty?

Is Web-based Test For Prediabetes Faulty?

MONDAY, Oct. 3, 2016 (HealthDay News) -- A simple, seven-question test for prediabetes may be needlessly sending millions of healthy Americans to their physicians for follow-up blood sugar testing, a new analysis suggests. The online screening tool aims to identify people at high risk of above-normal blood sugar levels, but not high enough to trigger a diagnosis of type 2 diabetes. The risk assessment test has been promoted by the U.S. Centers for Disease Control and Prevention, the American Diabetes Association and the American Medical Association. But, a study published Oct. 3 in JAMA Internal Medicine questions the usefulness of the test's findings. Using the web-based questionnaire, researchers found that 73 million people would be at high risk for prediabetes. That's 59 percent of adults 40 and older, the study authors said. Among adults over 60 years old, 81 percent had high risk scores, the study showed. To put that in context, fewer than 30 million Americans have a diagnosis of type 2 diabetes, according to the American Diabetes Association. "It [the test] falsely identifies a big majority of the population as having prediabetes while they are in fact normal," said Dr. Saeid Shahraz, one of the study authors. Shahraz is an assistant professor of medicine at Tufts Medical Center in Boston. Prediabetes can lead to full-blown diabetes, heart disease and stroke. But the condition can often be reversed with healthy lifestyle changes, the CDC says. Dr. Rita Redberg, editor-in-chief of JAMA Internal Medicine, said the study demonstrates how indicators of health -- in this case, blood sugar levels and other risk factors such as weight -- are being morphed into their own medical condition. "We suggest a better approach to preventing the epidemic of obesity and its multi Continue reading >>

Jabfp | Mobile

Jabfp | Mobile

Purpose: Detection and treatment of prediabetes is an effective strategy in diabetes prevention. However, most patients with prediabetes are not identified. Our objective was to evaluate the relationship between attitudes toward prediabetes as a clinical construct and screening/treatment behaviors for diabetes prevention among US family physicians. Methods: An electronic survey of a national sample of academic family physicians (n 1248) was conducted in 2016. Attitude toward prediabetes was calculated using a summated scale assessing agreement with statements regarding prediabetes as a clinical construct. Perceived barriers to diabetes prevention, current strategies for diabetes prevention, and perceptions of peers were also examined. Results: Physicians who have a positive attitude toward prediabetes as a clinical construct are more likely to follow national guidelines for screening (58.4% vs 44.4; P < .0001) and recommend metformin to their patients for prediabetes (36.4% vs 20.9%; P < .0001). Physicians perceived a number of barriers to treatment, including a patient's economic resources (71.9%), sustaining patient motivation (83.2%), a patient's ability to modify his or her lifestyle (75.3%), and time to educate patient (75.3%) as barriers to diabetes prevention. Conclusions: How physicians view prediabetes varies significantly, and this variation is related to treatment/screening behaviors for diabetes prevention. This study analyzed a survey conducted as part of the Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA). CERA is a joint initiative of all 4 major US academic family medicine organizations (the Society of Teachers of Family Medicine, the North American Primary Care Research Group, the Association of Departments of Family Med Continue reading >>

So...do I Have Prediabetes?

So...do I Have Prediabetes?

With a little exercise and a change in diet, it often can be reversed. Let's face it, there are millions of reasons why we don't find the time to make healthy lifestyle choices. Kids, jobs, cat videos on the Internet — we're busy. But whatever your reason, prediabetes is real. So find out if you have prediabetes by taking the test now. You won't regret it. Join the National DPP You're not alone in this. There are hundreds of Diabetes Prevention Programs in local communities that are proven to help people with prediabetes make lifestyle changes to prevent or delay type 2 diabetes. We're sure there's one that's right for you. "But I'm a busy mom...I don't have time to eat right and exercise!" Yes, making lifestyle changes may seem hard. But it doesn’t have to be. In fact, some of them can even be fun. Continue reading >>

Ezscan As A Screening Tool For Prediabetes And Diabetes In A Largemexican Population

Ezscan As A Screening Tool For Prediabetes And Diabetes In A Largemexican Population

Received date January 09, 2015; Accepted date February 28, 2015; Published date March 05, 2015 Citation: Sanchez Hernandez OE, Papacostas-Quintanilla H, Vilier A, Calvet JH, Jimnez Osorio A, et al. (2015) EZSCAN as a Screening Tool for Prediabetes and Diabetes in a Large Mexican Population. J Diabetes Metab 6:505. doi:10.4172/2155-6156.1000505 Copyright: 2015 Sanchez Hernandez OE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective: Autonomic neuropathy especially small C-Fibers innervating sweat glands is common in diabetes and occurs in pre-diabetes. EZSCAN, a new and non-invasive device that precisely assesses sudomotor function was evaluated as a screening tool for pre-diabetes and diabetes in a large Mexican population. Methods: The study was performed in Hospital Regional Lic. Adolfo Lopez Mateos ISSSTE center. Subjects were classified as pre-diabetic or diabetic according to ADA criteria for fasting plasma glucose (FPG) and HbA1C. EZSCAN test was performed and subjects were classified as no risk, moderate risk or high risk and its performance as a screening tool was assessed through ROC curve analysis. Results: Among the 1414 subjects involved in the study 357 had pre-diabetes and 64 had diabetes according to FPG confirmed by HbA1C for 52 of them. Area under the Curve for EZSCAN to detect pre-diabetes or diabetes using FPG as reference were 0.65 and 0.73 respectively. Using 27 and 34 as threshold values for EZSCAN risk score for detection of pre-diabetes and diabetes sensitivity was 69% and 73%, specificity 56% and 70% and negative predictive value 82% and 98% resp Continue reading >>

Cdc Turning'prediabetes' Into A Bogus Diagnosis

Cdc Turning'prediabetes' Into A Bogus Diagnosis

CDC Turning'Prediabetes' Into a Bogus Diagnosis The renewed campaign against Type-2 diabetes is in full force with the launch of DoIHavePrediabetes.org, the Centers for Disease Control and Prevention's most recent, well-meaning, but largely misguided effort. By utilizing a new screening tool, the federal health agency, which is partnered in the effort with the American Medical Association and the American Diabetes Association, is trying to encourage Americans to take an active role in managing their health -- which, of course, is a welcome goal. But in a medical environment often plagued by over-diagnosis and over-prescription, is this new tool -- which could potentially impact more than 80 million people -- really necessary? It seems like everyone has some kind of condition these days. For example, a fidgety kid suffers from hyperactivity, so what was once considered fairly-common excitability is now considered some sort of drug-treated disorder. While a few forgetful episodes by grandpa, and the next thing you know red flags start flying that he's on an irreversible path towards Alzheimer's. Of course, early detection of an illness -- chronic disease, in particular -- is encouraged. But where do we draw the line between practical caution and harmful zealousness? Which brings us to the concept of "prediabetes." First, what is it, and how is it identified? Upon examination, the classification process behind DoIHavePrediabetes.org appears to be oversimplified, and it puts just about everyone at some degree of risk simply because they are ... human. The CDC estimates that over 86 million people could be potentially affected by the condition, defined as having higher than normal blood glucose levels , but not quite high enough to be clinically diagnosed as diabetic. What' Continue reading >>

A New Diabetes Screening Tool To Promote Early Detection

A New Diabetes Screening Tool To Promote Early Detection

A New Diabetes Screening Tool to Promote Early Detection by Physicians Weekly | Jun 30, 2010 | 2 comments Heejung Bang, PhD, has indicated to Physicians Weekly that she has or has had no financial interests to report. Heejung Bang, PhD, has indicated to Physicians Weekly that she has or has had no financial interests to report. Researchers have developed and validated a simple self-assessment questionnaire for the detection of diabetes in an effort to identify more of the millions of patients who are unknowingly living with the disease. Research has shown that more than 60 million adults in the United States have diagnosed diabetes, undiagnosed diabetes, or prediabetes. Approximately 30% of diabetes cases are estimated to be undiagnosed, says Heejung Bang, PhD. Diabetes is a silent killer and many patients dont know they have it, but clinicians can help patients by steering them to assess their risk on their own. With the steadily increasing prevalence of the disease, prevention of diabetes has become a major health priority, and the identification of high-risk people who may benefit from early lifestyle interventions is paramount. National guidelines for diabetes screening are available to help detect undiagnosed disease. In addition, several risk assessment tools for prevalent or incident diabetes have been developed to identify patients who are most in need of screening. In the United States, national guidelines for diabetes screening have been released by the CDC, the American Diabetes Association (ADA), and the Preventive Services Task Force. In addition, two risk-scoring algorithms for undiagnosed diabetes have been derived from nationally representative samples. These methods have been developed using slightly different frameworks and purposes, but they are not Continue reading >>

Diabetes Mellitus: Screening And Diagnosis

Diabetes Mellitus: Screening And Diagnosis

Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, but may not reduce rates of end-organ damage. Randomized trials show that screening for type 2 diabetes does not reduce mortality after 10 years, although some data suggest mortality benefits after 23 to 30 years. Lifestyle and pharmacologic interventions decrease progression to diabetes in patients with impaired fasting glucose or impaired glucose tolerance. Screening for type 1 diabetes is not recommended. The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who are overweight or obese, and repeating testing every three years if results are normal. Individuals at higher risk should be considered for earlier and more frequent screening. The American Diabetes Association recommends screening for type 2 diabetes annually in patients 45 years and older, or in patients younger than 45 years with major risk factors. The diagnosis can be made with a fasting plasma glucose level of 126 mg per dL or greater; an A1C level of 6.5% or greater; a random plasma glucose level of 200 mg per dL or greater; or a 75-g two-hour oral glucose tolerance test with a plasma glucose level of 200 mg per dL or greater. Results should be confirmed with repeat testing on a subsequent day; however, a single random plasma glucose level of 200 mg per dL or greater with typical signs and symptoms of hyperglycemia likely indicates diabetes. Additional testing to determine the etiology of diabetes is not routinely recommended. Clinical r Continue reading >>

Implementation Of A Screening Procedure For Pre-diabetes (population Ages 19 And Older) In The Primary Care Setting

Implementation Of A Screening Procedure For Pre-diabetes (population Ages 19 And Older) In The Primary Care Setting

CHI Health > About CHI Health > Press Room > Publications > microscope > Nursing > Implementation of a Screening Procedure for Pre-diabetes Implementation of a Screening Procedure for Pre-diabetes (Population Ages 19 and Older) in the Primary Care Setting When she was a Creighton University nurse practitioner student, Abbey Modlin saw an 18-year-old female with abdominal pain, and happened to notice dark skin on the back of her neck indicative of excess insulin. On a hunch, she asked if the patient had a family history of diabetes. She did. That patient was the person who drove my thoughts on the importance of early screening for pre-diabetes regardless of the chief complaint, Modlin said. She was a prime candidate. The resulting research for Modlins DNP-FNP degree looked at whether the CDC screening tool for pre-diabetes was appropriate for the clinic setting, and was completed at Mercy Family Care in Perry, Iowa, and the Mercy Panora Clinic in Panora, Iowa. The tool takes less than a minute, she said. But its often missed due to time constraints in the clinic. In her study, 79 percent of patients scored high enough on the screening tool to receive pre-diabetes education. Modlins conclusion: the tool is useful to start the conversation about pre-diabetes with appropriate patients. Ive always used the term planting the seed, she said. Modlin presented her findings at the Creighton College of Nursing Iota Tau Chapter of Sigma Theta Tau International Nursing Honor Society Annual Research Day in May. Continue reading >>

Recommendations For Community-based Screening For Prediabetes And Diabetes

Recommendations For Community-based Screening For Prediabetes And Diabetes

AADE White Paper The high prevalence of prediabetes and diabetes represents a major health problem in the United States (U.S.). According to the Centers for Disease Control and Prevention (CDC), in 2012 persons with diabetes in the U.S. accounted for 9.3% of the nation’s population or 29.1 million people. Of those affected, only 21.0 million people were diagnosed with diabetes; thus, 8.1 million individuals (27.8%) were undiagnosed.1 In addition, the 2012 CDC statistics for the US population estimated that there were 86 million adults with prediabetes.1 Clearly, an unacceptably high percentage of persons with or at risk for diabetes in the U.S. are undiagnosed and, as a result, not receiving proper care to avoid or manage diabetes and its complications. Groups within the population who are at higher risk include individuals over 45 years of age, racial and ethnic minorities, women who have had gestational diabetes but do not receive adequate follow-up testing postpartum, and those without access to medical care, such as the uninsured.1,2,3 Given that our current prevalence of diabetes (9.3%) is nearly triple that of 1990 (3.6%), there is almost universal agreement that we must take effective steps to reduce the growth of this epidemic. Among such steps, there is strong support for earlier diagnosis and intervention to minimize the progression of diabetes and the development of associated complications.4-6 In response to the diabetes epidemic, many diabetes stakeholder groups and organizations in the U.S., especially at the local level, advocate for community-based screening (CBS) in venues such as health fairs or diabetes awareness events. Thousands of individuals throughout the nation have been and continue to be screened at such events in the hope that those wh Continue reading >>

Is Online Prediabetes Screening Reliable?

Is Online Prediabetes Screening Reliable?

Here at Diabetes Flashpoints, we’ve previously discussed some of the controversy surrounding a diagnosis of prediabetes — elevated blood glucose that isn’t high enough for a diagnosis of Type 2 diabetes. As we noted in that post, the American Diabetes Association (ADA) is virtually alone in recognizing prediabetes as a condition — the World Health Organization, for example, discourages use of the term and provides no diagnostic criteria. But due to the ADA’s influence worldwide, more and more doctors both in and outside the United States appear to be diagnosing prediabetes. Now, it seems that the ADA — in partnership with other American medical organizations — is doubling down on its emphasis of the dangers of prediabetes. A few months ago, it teamed up with the American Medical Association, the Centers for Disease Control and Prevention, and the Ad Council to create an online quiz that aims to estimate a person’s risk of developing prediabetes. The seven-question test asks participants about their gender, family history of diabetes, blood pressure, age, ethnicity, physical activity, and height and weight. As the home page of the quiz notes, “1 in 3 American adults has prediabetes” — and the quiz’s sponsors hope that this third of the population will visit their doctor if the quiz suggests a high risk of prediabetes. As a HealthDay article on the quiz notes, over a third of adults who take the quiz may end up having prediabetes. But according to an article published earlier this week in the journal JAMA Internal Medicine, about 60% of American adults age 40 or over — and over 80% of those age 60 or older — are likely to get a “high risk” result from the prediabetes quiz. To arrive at these numbers, researchers analyzed the results of ques Continue reading >>

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