This large randomized population based trial discloses a noticeable need for and acceptance of lifestyle intervention in the general population.

OBJECTIVE -To develop a simple self-administered questionnaire identifying individuals with undiagnosed diabetes with a sensitivity of 75% and minimizing the high-risk group needing subsequent testing. RESULTS -The final risk score included age, sex, BMI, known hypertension, physical activity at leisure time, and family history of diabetes, items independently and significantly (P Ͻ 0.05) associated with the presence of previously undiagnosed diabetes. The area under the receiver operating curve was 0.804 (95% CI 0.765-0.838) for the first half of the Inter99 population, 0.761 (0.720 -0.803) for the second half of the Inter99 population, and 0.803 (0.721-0.876) for the ADDITION pilot study. The sensitivity, specificity, and percentage that needed subsequent testing were 76, 72, and 29%, respectively. The false-negative individuals in the risk score had a lower absolute risk of ischemic heart disease compared with the true-positive individuals (11.3 vs. 20.4%; P Ͻ 0.0001). RESEARCH DESIGN AND METHODSCONCLUSIONS -We developed a questionnaire to be used in a stepwise screening strategy for type 2 diabetes, decreasing the numbers of subsequent tests and thereby possibly minimizing the economical and personal costs of the screening strategy.

OBJECTIVE -To determine the age-and sex-specific prevalence of impaired fasting glycemia, impaired glucose tolerance, screen-detected diabetes, and known diabetes in a Danish population aged 30 -60 years and to examine the phenotype and the cardiovascular risk profile in individuals with impaired glucose regulation.RESEARCH DESIGN AND METHODS -In the Inter99 study, 13,016 inhabitants living in Copenhagen County were invited. All participants underwent anthropometric measurements, blood samples, and a 75-g standardized oral glucose tolerance test.RESULTS -The age-specific prevalences in men were as follows: impaired fasting glycemia: 1.4 -16.3%; impaired glucose tolerance: 6.9 -17.8%; screen-detected diabetes: 0.7-9.7%; and known diabetes: 0 -5.8%. The corresponding figures in women were 0 -5.1, 10.5-17.3, 0.6 -6.3, and 0.5-9%. The prevalence of impaired glucose regulation increased with age. Among individuals with diabetes, 65.6% were previously undiagnosed; this proportion was highest in the youngest age-group (82% among 45-year-old men vs. 63% among 60-year-old men, and 70% among 45-year-old women vs. 52% among 60-year-old women). Mean BMI, waist, HbA 1c , systolic blood pressure, diastolic blood pressure, and total cholesterol were significantly higher (P Ͻ 0.0001) in the individuals with impaired glucose regulation compared with individuals with normal glucose tolerance.CONCLUSIONS -This study revealed that the prevalence of type 2 diabetes is high and that still two out of three individuals are undiagnosed, indicating a need for more attention to the disease in society. Diabetes Care 26:2335-2340, 2003T he number of people with type 2 diabetes is estimated to increase rapidly within the next 25 years (1), with an estimated 42% increase in developed countries. This prediction is only based on demographic changes in the population, without considering changes in lifestyle, and may thus represent a conservative estimate. In developed countries, the prevalence of overweight and obesity is increasing rapidly (2,3) because of reduced physical activity and overeating. This causes a rapid increase in the prevalence of diabetes (3,4). In Denmark, the prevalence of diabetes was 12.3% among 60-year-old men and 6.8% among women in 1996, representing an increase of 58% in men and 21% in women compared with 1974 -1975 (5). Several population-based studies have examined the prevalence of type 2 diabetes in northern Europe. The populations are typically Ն50 years of age (6,7), although in the Ely study, the population under investigation was 40 -65 years old (8). Only the Hoorn (6) and Rotterdam studies (7) reported age-and sex-specific prevalences of diabetes and impaired glucose tolerance (IGT) (aged Ͼ50 years). Among people with diabetes, at least 50% are unaware of the disease (6,9,10). People with impaired glucose regulation have an unfavorable cardiovascular risk profile compared with healthy people and therefore have a higher rate of cardiovascular disease and mortality (8,(11)(12)(13)(14). These arguments could fav...