The PREDICA study (PREdiction of diabetes from CApillary Blood Glucose) in the general population

Diabetes raises clinical and social concerns due to its chronic complications impairing both quality and expectancy of life. Diabetes prevention should be implemented in the general population, especially in people at risk (positive family history for diabetes, obese subjects, etc.) - and especially those with impaired glucose tolerance. In Italy prevalence of type 2 diabetes in is 4.5% (National Institute of Statistics, 2006 data), whereas scarce data is available on the number of subjects with abnormal glucose metabolism in the general population.To detect abnormalities in glucose metabolism in a non diabetic adult population attending offices of general practitioners. Primary end points were the assessments of subjects compliance with home capillary blood glucose measurement and the identification of those with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or latent diabetes. 50 general practitioners -in the cities of Rome and Frosinone (Central Italy)- consecutively enrolled 538 non diabetic subjects (175 M and 225 F, mean age 55±9 yrs; range 27-77) attending their practice. Subjects were instructed to perform 8 fasting and 8 two-hour post-meal glucose determinations over a period of 2 months. A form was filled in for general data recollection; a glucometer, needle-sticks and reactive stripes were provided to enrolled subjects who accepted to comply with the study requirements.Overall 90% of the study population performed at least 5 glucose determinations in the 2 months period (58% completed 13 to 16 glucose determinations; 68% 5 to 8 fasting and 2 hours post-meal measurements). Alterations in blood glucose -either fasting or post-prandial- were detected as follows: 22% of subjects were classified as IFG (>110 mg/dl) and 12% showed abnormal post-prandial glucose (>140 mg/dl), 14% showed at least one value of abnormal fasting or post-prandial glucose. Finally, 36 subjects (6%) were diagnosed with type 2 diabetes. An odds ratio of 2.3 was calculated, i.e. if at least 8 glucose measurements were performed, the percentage of subjects with IFG, IGT or overt diabetes could have reached 50%. The use of a glucometer among the general adult population can represent an easy to use tool in the detection of blood glucose metabolism alterations (IFG, IGT) or early diagnosis of diabetes.