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. 2010 Nov-Dec;36(6):887-93.
doi: 10.1177/0145721710386973. Epub 2010 Nov 1.

Observations and recommendations for community-based diabetes screenings

Brian West  1 , Punam Parikh  2 , Guedy Arniella  3 , Carol R Horowitz  1
Affiliations

Observations and recommendations for community-based diabetes screenings

Brian West et al. Diabetes Educ. 2010 Nov-Dec.

Abstract

Purpose: Community-based diabetes screening is common, but its impact on health outcomes is unclear. Screening protocols may not be standardized nor reflect current clinical practice. A community and clinical team examined the quality and consistency of community-based screening to diagnose hyperglycemic states, and it developed a bilingual screening tool to allow screeners to present accurate, actionable results to participants.

Methods: The team interviewed providers and community members, analyzed forms and educational materials utilized by screeners, and observed local diabetes screening events. Researchers compared glucose parameters used by screeners to published guidelines and observed fingerstick techniques and protocols for education, referral, and follow-up. Screening was divided into 3 phases: participant assessment before testing, obtainment of a sample, and interpretation of and counsel about results.

Results: There was a general lack of consistency in diabetes screening practices at the 12 screenings attended and among the 11 screeners interviewed. Assessment rarely included evaluation of diabetes risk factors or recent caloric intake. Obtaining a sample through fingersticks often included practices known to cause discomfort and decrease accuracy of glucose measurements. Criteria used to categorize results as "normal" or "abnormal" rarely followed published guidelines for laboratory-measured glucose values and varied significantly between screeners. No organization mentioned prediabetes in screenings. Postscreening consultation protocols varied widely.

Conclusions: Inconsistencies and inaccuracies in screening practices may limit the quality and relevance of community-based diabetes screenings. The impact of local screenings may be enhanced by using a tool that includes concrete steps and precise guidelines.

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Figures

Figure 1
Figure 1
Published guidelines for assessing glucose. OGTT, oral glucose tolerance test. Copyright © 2007 American Diabetes Association. From http://www.diabetes.org. Reprinted with permission from the American Diabetes Association.
Figure 2
Figure 2
Community diabetes screening tool.
See this image and copyright information in PMC

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