Population-Based Study of Impaired Glucose Tolerance and Type II Diabetes in Wadena, Minnesota

Abstract

The Wadena City Health Study was undertaken to assess the nature of type II (non-insulin-dependent) diabetes and its relationship to aging. This article reports the study methodology and prevalence estimates for type II diabetes and impaired glucose tolerance (IGT) for the adult population of Wadena, Minnesota. The sampling frame for the study included all known diabetic individuals and all other residents based on a complete citywide census of residents greater than or equal to 20yr of age. A stratified random sample that included three stratifying factors (age [20-39, 40-59, greater than or equal to 60 yr], sex, and self-reported weekly use of any prescribed medication was drawn from the other residents). The study protocol required diet preparation and two full mornings of testing. Data collected included height, weight, and blood pressure measurements and both a personal interview and a medications questionnaire. A 75-g oral glucose tolerance test (OGTT) and a test with a standard liquid meal (Ensure-Plus challenge test [EPCT], Ross) were done on two mornings, with the order of testing randomly assigned. Clinical tests included one-time samples for hemoglobin, glycosylated hemoglobin, plasma cholesterol, triglycerides, and lipoproteins. Blood samples for glucose and creatinine assays were taken during the OGTT; blood samples for glucose, free fatty acid, creatinine, and C-peptide were taken during the EPCT. Urine collections were performed for both challenge tests and assayed for C-peptide and creatinine. Seventy-one percent of the known diabetic subjects, and 65% of the stratified random sample participated in the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of Diabetes and Impaired Glucose Tolerance in Funagata Area, Japan

“…The prevalence of IGT in Funagata is 16.6%, compared with 11.9% for diabetes. Thus, IGT comprises 60% of all glucose intolerance, and this ratio is compatible with that of other studies (2,5,6,17). The prevalence of IGT was found to increase in people between 45 and 75 yr of age, with no sex predominance.…”

“…The age-related increase in prevalence of diabetes mellitus reported previously (2,(5)(6)(7)(8)(9)(12)(13)(14) was also the case in this study. IGT is a relatively new clinical category, and its clinical significance is still under study (15).…”

“…The prevalence of undiagnosed diabetes has been shown to be about equal to that of diagnosed diabetes in several studies (2,5,6), as also demonstrated by our survey. Mass screening by examining urinary glucose has been conducted in this area for many years, and the cases of diagnosed diabetes include not only those diagnosed at hospitals and clinics but also those detected by mass screening.…”

“…To ascertain the prevalence of diabetes mellitus, a sample study (2,5,6) or GTT involving the entire population group (7-9) must be conducted. The prevalence of diabetes mellitus in three studies done in Japan with WHO criteria (10) or NDDG criteria (11) was 4.0, 3.6, and 3.7% (12)(13)(14).…”

Community Screening for Diabetes: Low detection rate in a low-risk population

“…Community diabetes screening with blood glucose is a costly, potentially risky undertaking and has a small diabetes detection frequency when measured against current epidemiological survey information (6,7,8). These data support the ADA white paper position of abandoning glucose-based community screening.…”