The online version of this article (doi:10.1007/s00125-017-4299-y) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
There is continuing debate about the net benefits of population screening for type 2 diabetes. We compared the risk of cardiovascular disease (CVD) and mortality among incident cases of type 2 diabetes in a screened group with those in an unscreened group.
In this register-based non-randomised controlled trial, eligible individuals were all men and women aged 40–69 years without known diabetes, registered with a general practice in Denmark (n = 1,912,392). Between 2001 and 2006, 153,107 individuals registered with 181 practices participating in the Anglo–Danish–Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION)-Denmark study were sent a diabetes-risk-score questionnaire. Individuals at moderate-to-high risk were invited to visit their family doctor for assessment of diabetes status and cardiovascular risk (screening group). The 1,759,285 individuals registered with all other practices in Denmark constituted the retrospectively constructed no-screening (control) group. In this post hoc analysis, we identified individuals from the screening and no-screening groups who were diagnosed with diabetes between 2001 and 2009 (n = 139,075), and compared risk of CVD and mortality in these groups between 2001 and 2012.
In the screening group, 27,177/153,107 (18%) individuals attended for screening, of whom 1533 were diagnosed with diabetes. Between 2001 and 2009, 13,992 people were newly diagnosed with diabetes in the screening group (including those diagnosed by screening) and 125,083 in the no-screening group. Between 2001 and 2012, the risks of CVD and mortality were lower among individuals with diabetes in the screening group compared with individuals with diabetes in the no-screening (control) group (CVD HR 0.84, 95% CI 0.80, 0.89; mortality HR 0.79, 95% CI 0.74, 0.84).
A single round of diabetes screening and cardiovascular risk assessment in middle-aged Danish adults in general practice was associated with a significant reduction in risk of all-cause mortality and CVD events in those diagnosed with diabetes.
ESM Table 1 (PDF 10 kb)125_2017_4299_MOESM1_ESM.pdf
Herman WH, Ye W, Griffin SJ et al (2015) Early detection and treatment of type 2 diabetes reduce cardiovascular morbidity and mortality: a simulation of the results of the Anglo-Danish-Dutch study of intensive treatment in people with screen-detected diabetes in primary care (ADDITION-Europe). Diabetes Care 38:1449–1455 CrossRefPubMedPubMedCentral
Department of Health (2008) Putting prevention first. Vascular checks: risk assessment and management. Department of Health, London
Simmons RK, Griffin, S.J., Witte, D.R., Borch-Johnsen, K., Lauritzen, T., Sandbæk, A. (2016) Effect of population screening for cardiovascular risk factors and type 2 diabetes on mortality and cardiovascular events among 1,912,392 Danish adults. Diabetologia DOI: 10.1007/s00125-017-4323-2
Lauritzen T, Griffin S, Borch-Johnsen K, Wareham NJ, Wolffenbuttel BH, Rutten G (2000) The ADDITION study: proposed trial of the cost-effectiveness of an intensive multifactorial intervention on morbidity and mortality among people with type 2 diabetes detected by screening. Int J Obes Relat Metab Disord 24(Suppl 3):S6–11 CrossRefPubMed
Green A, Sortso C, Jensen PB, Emneus M (2015) Validation of the Danish national diabetes register. Clin Epidemiol 7:5–15 PubMed
UNESCO (1997) International Standard Classification of Education. Available from http://www.unesco.org/education/information/nfsunesco/doc/isced_1997.htm. Accessed 20 Apr 2017
Huber PJ (1967) The behavior of maximum likelihood estimates under nonstandard conditions. In: Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability. University of California Press, Berkeley, pp 221–233
Rahman M, Simmons RK, Hennings SH, Wareham NJ, Griffin SJ (2011) How much does screening bring forward the diagnosis of diabetes and reduce complications? 12-year follow-up of the Ely cohort. Diabetologia 55:1651–1659 CrossRef
Danish National Health Service survey (2004). Available from https://www.sst.dk/da/sundhed-og-livsstil/tobak/tal-og-fakta/danskernes-rygevaner/2004. Accessed 20 Apr 2017
- Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009
Rebecca K. Simmons
Simon J. Griffin
- Springer Berlin Heidelberg
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II