| Screening uncovers a lot of unsuspected
diabetes
By Alison McCook
NEW YORK (Reuters Health) - Community-based screenings of people
living in the Bronx, New York, revealed that nearly 25 percent either
have or are at risk of diabetes, and don't know it.
Although diabetes can lead to a host of complications, those can
take years to develop, study author Dr. Charles Nordin explained.
Consequently, just like high blood pressure, people can live with
diabetes for a very long time before they realize they are in danger,
he said.
"Diabetes can also be a silent killer," he told Reuters
Health.
He recommended that every person with known risk factors - such
as obesity, high blood pressure, heart disease, or a family history
of diabetes - should be screened regularly for diabetes.
Nordin, of Jacobi Medical Center, and his team set up screening
centers at churches, group homes, shelters, community centers and
street corners in the Bronx, a relatively deprived area. As part
of the screening, they measured levels of hemoglobin A1c (HbA1c),
a marker for long-term increases in blood sugar.
An HbA1c value of between 6 and 7 percent suggests a person is
at risk of developing the disease, while anything over 7 percent
indicates full-blown diabetes.
After screening more than 700 people, Nordin's group discovered
that 13 percent knew they had the disease. However, an additional
24 percent had HbA1c levels that exceeded 6 percent, and were entirely
unaware that they were at risk of diabetes. Between 3 and 4 percent
of people unknowingly had HbA1cs that exceeded 7 percent.
People with HbA1cs above 6 percent had more risk factors for cardiovascular
disease than people with lower HbA1cs, according to the report in
the American Journal of Preventive Medicine.
"I would hope that our approach will bring more people at
the early stages of this disease to physicians, so that our excellent
treatments can be started in time to delay or even prevent the dreaded
complications of the disease," Nordin said.
Inner city neighborhoods have higher rates of diabetes than others,
and conducting random screenings like those that took place in this
study may help doctors identify and treat people before it's too
late, the researcher noted.
"I would like to see the medical community uses our example
to become more proactive about getting out from the hospitals into
neighborhoods to check people for diabetes and other cardiovascular
risk factors," he said.
SOURCE: American Journal of Preventive Medicine, May 2004.
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