Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 19;22(1):168.
doi: 10.1186/s12916-024-03393-0.

Undiagnosed type 2 diabetes is common - intensified screening of established risk groups is imperative in Sweden: the SDPP cohort

Hrafnhildur Gudjonsdottir  1   2 , Per Tynelius  3   4 , Nouha Saleh Stattin  5   6 , Diego Yacamán Méndez  3   4 , Anton Lager  3   4 , Boel Brynedal  3   4
Affiliations

Undiagnosed type 2 diabetes is common - intensified screening of established risk groups is imperative in Sweden: the SDPP cohort

Hrafnhildur Gudjonsdottir et al. BMC Med. .

Abstract

Background: Undiagnosed type 2 diabetes (T2D) is a global problem. Current strategies for diagnosis in Sweden include screening individuals within primary healthcare who are of high risk, such as those with hypertension, obesity, prediabetes, family history of diabetes, or those who smoke daily. In this study, we aimed to estimate the proportion of individuals with undiagnosed T2D in Stockholm County and factors associated with T2D being diagnosed by healthcare. This information could improve strategies for detection.

Methods: We used data from the Stockholm Diabetes Prevention Programme (SDPP) cohort together with information from national and regional registers. Individuals without T2D aged 35-56 years at baseline were followed up after two ten-year periods. The proportion of diagnosed T2D was based on register information for 7664 individuals during period 1 and for 5148 during period 2. Undiagnosed T2D was assessed by oral glucose tolerance tests at the end of each period. With logistic regression, we analysed factors associated with being diagnosed among individuals with T2D.

Results: At the end of the first period, the proportion of individuals with T2D who had been diagnosed with T2D or not was similar (54.0% undiagnosed). At the end of the second period, the proportion of individuals with T2D was generally higher, but they were less likely to be undiagnosed (43.5%). The likelihood of being diagnosed was in adjusted analyses associated with overweight (OR=1.85; 95% CI 1.22-2.80), obesity (OR=2.73; 95% CI 1.76-4.23), higher fasting blood glucose (OR=2.11; 95% CI 1.67-2.66), and self-estimated poor general health (OR=2.42; 95% CI 1.07-5.45). Socioeconomic factors were not associated with being diagnosed among individuals with T2D. Most individuals (>71%) who developed T2D belonged to risk groups defined by having at least two of the prominent risk factors obesity, hypertension, daily smoking, prediabetes, or family history of T2D, including individuals with T2D who had not been diagnosed by healthcare.

Conclusions: Nearly half of individuals who develop T2D during 10 years in Stockholm County are undiagnosed, emphasizing a need for intensified screening of T2D within primary healthcare. Screening can be targeted to individuals who have at least two prominent risk factors.

Keywords: Healthcare; Public health; Risk factors; Screening; Type 2 diabetes; Undiagnosed.

PubMed Disclaimer

Conflict of interest statement

None to declare.

Figures

Fig. 1
Fig. 1
Source and time of data gathering and the number of eligible participants.SDPP: The number of eligible individuals who participated in the clinical examinations at follow-ups in the SDPP cohort
Fig.2
Fig.2
The proportion of individuals who belong to a risk group. The proportion of individuals with at least two risk factors (obesity, family history of diabetes, hypertension, daily smoking, or prediabetes) for T2D development among individuals without T2D, with diagnosed and undiagnosed T2D at the start of the period, in period 1 and period 2, respectively
See this image and copyright information in PMC

References

    1. Global burden of disease. GBD Compare 2022. Available from: https://vizhub.healthdata.org/gbd-compare/. Accessed 13 Aug 2023.
    1. Nwaneri C, Cooper H, Bowen-Jones D. Mortality in type 2 diabetes mellitus: magnitude of the evidence from a systematic review and meta-analysis. Br J Diab Vasc Dis. 2013;13(4):192–207. doi: 10.1177/1474651413495703. - DOI
    1. Kenny HC, Abel ED. Heart Failure in Type 2 Diabetes Mellitus. Circ Res. 2019;124(1):121–41. doi: 10.1161/CIRCRESAHA.118.311371. - DOI - PMC - PubMed
    1. Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet (London, England). 2010;375(9733):2215–22. doi: 10.1016/S0140-6736(10)60484-9. - DOI - PMC - PubMed
    1. UK Prospective Diabetes Study (UKPDS) Group Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) Lancet. 1998;352(9131):837–53. doi: 10.1016/S0140-6736(98)07019-6. - DOI - PubMed