Two-stage, school and community-based population screening successfully identifies individuals and families at high-risk for type 2 diabetes: The Feel4Diabetes-study

Manios, Y. ; Mavrogianni, C. ; Lambrinou, C.P. ; Cardon, G. ; Lindström, J. ; Iotova, V. ; Tankova, T. ; Civeira, F. (Universidad de Zaragoza) ; Kivelä, J. ; Jancsó, Z. ; Shadid, S. ; Tsochev, K. ; Mateo-Gallego, R. (Universidad de Zaragoza) ; Radó, S. ; Dafoulas, G. ; Makrilakis, K. ; Androutsos, O.

Resumen: Background: The implementation of population screening and early prevention strategies targeting individuals at high-risk for type 2 diabetes (T2D) seems to be a public health priority. The current work aimed to describe the screening procedure applied in the Feel4Diabetes-study and examine its effectiveness in identifying individuals and families at high risk, primarily for T2D and secondarily for hypertension, among vulnerable populations in low to middle-income countries (LMICs) and high-income countries (HICs) across Europe. Methods: A two-stage screening procedure, using primary schools as the entry-point to the community, was applied in low socioeconomic status (SES) regions in LMICs (Bulgaria-Hungary), HICs (Belgium-Finland) and HICs under austerity measures (Greece-Spain). During the first-stage screening via the school-setting, a total of 20, 501 parents (mothers and/or fathers) of schoolchildren from 11, 396 families completed the Finnish Diabetes Risk Score (FINDRISC) questionnaire, while their children underwent anthropometric measurements in the school setting. Parents from the identified "high-risk families" (n = 4484) were invited to participate in the second-stage screening, including the measurement of fasting plasma glucose (FPG) and blood pressure (BP). In total, 3153 parents participated in the second-stage screening (mean age 41.1 ± 5.6 years, 65.8% females). Results: Among parents who attended the second-stage screening, the prevalence of prediabetes (as defined by impaired fasting glucose; FPG 100-125 mg/dl) and T2D (FPG > 126 mg/dl) was 23.2 and 3.0% respectively, and it was found to be higher in the higher FINDRISC categories. The percentage of undiagnosed T2D among the participants identified with T2D was 53.5%. The prevalence of high normal BP (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg) and hypertension (systolic BP = 140 mmHg and/or diastolic BP = 90 mmHg) was 14 and 18.6% respectively, which was also higher in the higher FINDRISC categories. The percentage of cases not receiving antihypertensive treatment among the participants identified with hypertension was 80.3%. Conclusion: The findings of the current study indicate that the two-stage school and community-based screening procedure followed, effectively identified high-risk individuals and families in vulnerable populations across Europe. This approach could be potentially scalable and sustainable and support initiatives for the early prevention of T2D and hypertension.

Idioma: Inglés

DOI: 10.1186/s12902-019-0478-9

Año: 2020

Publicado en: BMC endocrine disorders 20, Suppl 1 (2020), 12 [11 pp.]
ISSN: 1472-6823

Factor impacto JCR: 2.763 (2020)

Categ. JCR: ENDOCRINOLOGY & METABOLISM rank: 110 / 145 = 0.759 (2020) - Q4 - T3

Factor impacto SCIMAGO: 0.743 - Medicine (miscellaneous) (Q2) - Endocrinology, Diabetes and Metabolism (Q2)

Financiación: info:eu-repo/grantAgreement/EC/H2020/643708/EU/Developing and implementing a community-based intervention to create a more supportive social and physical environment for lifestyle changes to prevent diabetes in vulnerable families across Europe/Feel4Diabetes

Tipo y forma: Article (Published version)

Área (Departamento): Área Enfermería (Dpto. Fisiatría y Enfermería)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)