Clinical characteristics and follow‐up of subjects with non‐insulin‐dependent diabetes mellitus diagnosed by screening

There is increasing evidence for the need to screen for non‐insulindependent diabetes mellitus (NIDDM). However, little is known about the clinical characteristics of subjects with NIDDM diagnosed by screening. We present data from 109 subjects with NIDDM diagnosed by such means. The majority (59%) were male, 59% were obese and 25% had a previous history of hypertension. At diagnosis mean fasting glucose concentration was 10.8mmol/l and mean cholesterol concentration was 6.7mmol/l with only 14% of subjects having a cholesterol concentration less than 5.2mmol/l. Forty eight per cent of subjects had a systolic blood pressure greater than 160mmHg and 68% of subjects had a diastolic blood pressure in excess of 90mmHg.

Eighty two subjects underwent a review for the presence of complications; 8% had evidence of retinopathy, 15% of neuropathy and 2% of foot ulceration. Twelve weeks after diagnosis there was a significant fall in fasting glucose concentration (p<0.001), systolic blood pressure (p<0.02), and diastolic blood pressure (p<0.009). There was a mean weight loss of 3.0kg (p<0.0001).

Screening for NIDDM identifies a group of subjects with significant cardiovascular risk factors and substantial numbers with retinopathy and neuropathy. The latter need regular medical review and hence the earlier they are detected the better. Early follow‐up suggests that simple dietary advice and diabetes education in subjects whose diabetes is identified in such a fashion is very effective both in terms of improved glycaemic control and weight reduction.