Sc05.05 Screening For Type 2 Diabetes And 3 Year Follow-Up In A Family Doctor's Praxis

Conference: 
Author(s): 
S. M. Pusarnig;
general practitioner, Vienna, Austria.
Susanne M Pusarnig
general practitioner
Ketzergasse 435
Vienna
Zip: 1230
Austria
Email: ordination@pusarnig.at
Phone: 0043 699 1788 7225
Text: 
Individuals with undiagnosed type 2 diabetes are at a high risk for stroke, coronary heart disease and peripheral vessel disease. Early detection and proper treating may reduce complications. The Finnish Diabetes Risk Score (FINDRISK) questionnaire is a practical screening tool to estimate the diabetes risk.
In 2008, we asked patients of our office to hand out FINDRISK forms to healthy subjects in their personal environment - family, relatives, neighbours? We rewarded them with small gifts for returning questionnaires, for the 10 persons that brought us the most we had a official ceremony.
Totally we received 1487 answered questionnaires. Against our expectations and former findings there were only 327 (22%) with FINDRISK-score 12 or higher.
High risk subjects were invited to a half-day workshop, in groups of 10 - 12 persons. We performed an Oral Glucose Tolerance Test (OGTT), HbA1c and provided general information during the OGTT - about ?things that everybody, healthy or not, should know about diabetes?. After 3 hours, the results of the OGTT and HbA1c were handed out and explained while having breakfast together.
From the 327 tested subjects, we found 89 (27%) newly diagnosed type 2 diabetics. They were immediately provided with a meter and information about healthy lifestyle. Because of the inspiring atmosphere in those groups, they seemed less afraid of the diagnosis and rather curious to test their blood sugar.
All of them were invited to participate in the Austrian Disease Management Program ?Therapie aktiv?, 78 persons (88%) agreed. They took part in a 9 hour Diabetes-Course and are ever since part of our diabetes program.
Outcome after 3-years: 71 (80%) persons still participating, the mean HbA1c is now 6,3% (+/- 0,7), one NSTEMI, 3 STEMIs and 1 stroke occurred in the first 3 years after diagnosis.
46 persons (52%) take part in exercise programs.
We find working with this group of diabetics very inspiring and encouraging. We think that the good adherence and compliance of those patients may result from a personal and motivating approach in the beginning and from their good personal relationship with their ?diabetes team in a family doctor?s setting?.
Literature: 
SC05.05
Screening for type 2 diabetes and 3 year follow-up in a family doctor's praxis