Detection of type 2 diabetes mellitus in general practice: do the patients' dossiers provide clues?

Abstract

In a general practice the history of all known 67 type 2 diabetes patients was compared with that of randomly chosen sex/age matched control persons who did not develop diabetes. All medical dossiers were scrutinized up to at least ten years before the diagnosis diabetes was made to establish determinants in patients' dossiers that correlate with a later diagnosis of diabetes mellitus. The history of the type 2 diabetes patients (43 female, 24 male) revealed signi®cantly more ®rst degree related members with known type 2 diabetes (64% versus 13%), body mass index >27 (63% versus 28%), hypertension (69% versus 37%), prescribed diuretics (54% versus 22%), hypertension with prescribed diuretics (46% versus 18%) and hypertension with BMI >27 (51% versus 19%). The same applied to the female type 2 diabetes patients taken separately. In the women with later type 2 diabetes 44% (controls 5%) of the pregnancies were complicated by toxicosis or a high birth weight. In the dossiers of the male diabetic patients only obesity was signi®cantly more recorded compared with the dossiers of the controls. On the basis of the above mentioned ®ndings the general practitioner/family physician should perform case ®nding for type 2 diabetes. In this way especially women may be recognized as diabetic patients at an early stage.