Up to 60,000 diabetes cases hidden in electronic records

GPs could find undiagnosed diabetes cases in existing patient data.

Existing electronic patient records could help GPs diagnose up to 60,000 undiagnosed diabetes cases, claim UK researchers.

Analysis of over 3.6 million anonymised electronic patient records collected from UK GP practices showed that existing records suggest that 1 per cent may have diabetes or glucose intolerance.

Using data from the QRESEARCH database, which holds information from 480 practices, researchers searched existing blood glucose data.

First they eliminated known cases of diabetes or patients for whom diabetes was ruled out.

Next, they looked for patients at risk of diabetes, those with a random blood glucose level of at least 11.1mmol/l or a fasting glucose of at least 7.0mmol/l (category A). Patients with a random or fasting blood glucose of at least 7.0mmol/l were considered at risk of impaired glucose tolerance (IGT) and put in category B.

This showed that 0.1 per cent were in category A and 0.9 per cent in category B.

Extrapolating this to a practice with 7,000 patients, for example, could mean eight have biochemical evidence of undiagnosed diabetes and 68 have results suggesting the need for further follow-up.

Study lead Dr Tim Holt, who is a researcher at Warwick University and a working GP, now plans further research to determine if calling in these at-risk patients would be worthwhile.

'If it turns out that that is a high number then we've made an important inroad into the problem of diagnosing diabetes,' he said.

Many of the cases are missed because of problems with the follow-up system, such as laboratories labelling fasting glucose tests as random, or patients failing to come in for follow-up, added Dr Holt.

Dr Brian Karet, diabetes educational lead at Bradford and Airedale Teaching PCT, said: 'It's not really screening, but trawling through for errors.

'If there's no costs involved then it would be worthwhile.'

In January, prime minister Gordon Brown pledged to make sure everyone who wanted to could be screened for a range of conditions, including diabetes. Details of this screening programme will be announced in March, according to the DoH.

rachel.liddle@haymarket.com

BJGP 2008; 58: 192-6

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