Research from Aarhus University now shows that screening for diabetes can reduce mortality rates and the risk of developing cardiovascular diseases for people who receive an early diabetes diagnosis. Data from two million Danes has been incorporated in two studies investigating the effect of early detection.

2017.08.28 | Helle Horskjær Hansen

The screening of patients with diabetes by a general practitioner is not only able to reduce their risk of cardiovascular disease. It can also extend their lives.

The mortality rate was approximately 20 per cent lower among people whose diabetes had been discovered by screening compared with the control group who had not been screened. Correspondingly, 16 per cent fewer screened patients developed cardiovascular diseases.

This is shown by new results from the ADDITION study, which will be published today in the journal Diabetologia, Journal of the European Association for the Study of Diabetes.

"For the patients who developed diabetes, screening for diabetes was associated with a reduced level of mortality or cardiovascular diseases," says Rebecca Simmons from the Aarhus Institute of Advanced Studies (AIAS), Aarhus University, who has headed the studies.

Between 2001 and 2006, a screening programme was introduced in five Danish counties, and more than 150,000 patients aged between 40-69 received information from the general practitioners who participated in the ADDITION Denmark study.

The patients had to answer a questionnaire that scored their risk of diabetes. If their score was moderate to high, they were invited to participate in a diabetes test at their general practitioner, where their risk of developing cardiovascular disease was assessed. More than 27,000 participated in the screening. Additionally, in the actual study a control group of approximately 1,760,000 people was established. This group were not offered the screening in the ADDITON study. All patients were followed for 9.5 years.

Stopped smoking and lost weight
Only a smaller proportion – approximately ten per cent – of the people with diabetes in the screening group were diagnosed by the screening initiative. The researchers therefore believe it to be likely that the screening programme had other effects than the actual early detection of diabetes.

For example, the general practitioners in the screening group provided life style advice and thereby delayed the diagnosis among those who turned out to be at risk of developing diabetes. One third of the diabetics who were diagnosed at the screening had given up smoking during the course of the study. Similarly, the patients had an average weight loss of two kilograms during the project period.  

“It would seem that an intensified detection effort may therefore result in beneficial effects for everyone who was diagnosed with diabetes during the period. This applies regardless of whether they were discovered by screening or because they had symptoms. This may be due to the fact that the general practitioners who participated in the initiative have been more aware of people at risk, and that they have had better tools for both diagnosis and treatment," says Rebecca Simmons.

Researchers believe that the screening can have an even greater effect if efforts are made to target the groups of people with the highest risk of developing diabetes and cardiovascular disease.

"We can target screening towards high risk groups, we can maximise participation by repeated invitations and we can improve treatment efforts," she says.

The research results – more information

The study is a cohort study of two million Danes.

Financing: The study is financed by public and private funding, see www.tilføjelse.au.dk 

Read Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults and

Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009

Contact

Professor and Research Director Annelli Sandbæk
Aarhus University, Department of Public Health – Section for General Medical Practice and
The Research Unit for General Practice
Mobile: (+45) 2128 2073
Email: annelli.sandbaek@ph.au.dk