Diabetes screening: a pending issue in hypertense/obese patients

Armina Sepehri; Antonio Palazón-Bru; Vicente Francisco Gil-Guillén; Dolores Ramírez-Prado; Felipe Navarro-Cremades; Ernesto Cortés; María Mercedes Rizo-Baeza

doi:10.7717/peerj.914

Diabetes screening: a pending issue in hypertense/obese patients

PeerJ. 2015 Apr 23:3:e914. doi: 10.7717/peerj.914. eCollection 2015.

Authors

Armina Sepehri¹, Antonio Palazón-Bru¹, Vicente Francisco Gil-Guillén¹, Dolores Ramírez-Prado¹, Felipe Navarro-Cremades¹, Ernesto Cortés², María Mercedes Rizo-Baeza³

Affiliations

¹ Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante, Alicante , Spain.
² Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University , San Juan de Alicante, Alicante , Spain.
³ Department of Nursing, University of Alicante , San Vicente del Raspeig, Alicante , Spain.

Abstract

The literature about possible cardiovascular consequences of diagnostic inertia in diabetes is scarce. We examined the influence of undetected high fasting blood glucose (FBG) levels on the cardiovascular risk and poor control of cardiovascular risk factors in hypertensive or obese patients, with no previous diagnosis of diabetes mellitus (i.e., diagnostic inertia). A cross-sectional study during a preventive program in a Spanish region was performed in 2003-2004. The participants were aged ≥40 years and did not have diabetes but were hypertensive (n = 5, 347) or obese (n = 7, 833). The outcomes were high cardiovascular risk (SCORE ≥5%), poor control of the blood pressure (≥140/90 mmHg) and class II obesity. The relationship was examined between FBG and the main parameters, calculating the adjusted odd ratios with multivariate models. Higher values of FBG were associated with all the outcomes. A more proactive attitude towards the diagnosis of diabetes mellitus in the hypertensive and obese population should be adopted.

Keywords: Delayed diagnosis; Diabetes mellitus; Hypertension; Obesity; Physician’s practice patterns; Primary health care.

Grants and funding

The Conselleria de Sanitat (Valencian Community) gave permission and financial support for this study. This public organism subsidized and authorized this study exclusively to determine the situation in patients attending their health center. It played no part in the study design, data collection, analysis or interpretation, writing the manuscript or the decision to send it for publication. The grant was used to contract a person (Antonio Fernández) to collect and computerize the data. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.