• Niloufer Sultan Ali
  • Ali Khan Khuwaja


Background: Diabetes Mellitus is a disease which remains asymptomatic for long duration oftime and usually diagnosed either when gets complicated or by routine or opportunistic screening.The practice of universal screening is not recommended, particularly in constraint resources.However, we embarked with a study to assess the yield of recommended screening f or Type 2diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. Methods: Allthe information required for this study was collected from medical records of all newly recruitedemployees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over aperiod of 5 months (August 2004 to December 2004). Out of 360 subjects , 326, whoseinformation was found to be complete, were included for final analysis. Results: Mean age of thestudy subjects was 25.3 ± 4.7 years and their mean casual plasma glucose level was 99.1 ± 16.3mg/dl. 315 (96.6%) study subjects had casual plasma glucose level of 139 mg/dl or less. Only 10(3.1%) study subjects had casual plasma glucose levels between 140 to 199 mg/dl. Just oneemployee, 41 years old, was found to have casual plasma glucose level of 213 mg/dl. Conclusion:In this study, screening of all individuals for diabetes had a very low yield. Recommendation ofuniversal screening for diabetes does not represent a good use of resources and perhaps not costeffective. However, periodic screening of high risk individuals should be warranted.Key words: Diabetes; Screening; Population; Cost-effectiveness


American Diabetes Association. Screening for type 2

diabetes. Diabetes Care 2004; 27: S11-S14

U.S. Preventive Services Task Force. Guide to clinical

preventive services: report of the U.S. Preventive Services

Task Force. 2nd ed. Baltimore: Williams & Wilkins; 1996.

U.S. Preventive Services Task Force. Screening for Type 2

Diabetes Mellitus in Adults: Recommendations and

Rationale: Annals of Internal Medicine 2003;138(3): 212-

American Diabetes Association. Standards of medical care in

diabetes–2006. Diabetes Care 2006; 29: S4-S36.

Goyder EC, Irwing LM. Screening for type 2 diabetes

mellitus: a decision analytic approach. Diabet Med 2000;17:


Ko Gt, Chan JC, Tsang LW, Yeung VT, Chow CC, Cockram

CS. Outcomes of screening for diabetes in high-risk Hong

Kong Chinese subjects. Diabetes Care 2000;23:1290-1294.

Lee DS, Reminton P, Madagame J, Blustein J. A cost

analysis of community screening for diabetes in the central

Wisconsin Medicare population (results from the MetaStar

pilot project in Wausau). WMJ 2000;99:39-43.

Lindahl B, Weinehall L, Asplund K, Hallmans G. Screening

for impaired glucose tolerance. Results from a populationbased study in 21, 057 individuals. Diabetes Care


World Health Organization. Diabetes Mellitus. Fact sheet

No.138. Available at:

Accessed on: 4/4/2006.

Lawrence JM, Bennett P, Young A, Robinson AM.

Screening f or diabetes in general practice: cross sectional

population study. BMJ 2001; 323: 548-551.

Staged Diabetes Management. Detection & Treatment Quick

Guide. 2 nd ed. International Diabetes Center. Institute for

Research and Education 3800 Park Nicollet Boulevard; 1999.


American College of Obstetricians and Gynecologists.

Guidelines for Women’s Health Care. 2 nd ed. Washington,

DC: American Coll of Obstetricians and Gynecologists;

p 210-3.

Lawrence J, Robinson A. Screening for diabetes in general

practice. Prev Cardiol 2003; 6: 78-84.

World Health Organization. Screening for Type 2 Diabetes.

Report of a World Health Organization and International

Diabetes Federation meeting. World Health Organization.

Department of Non-communicable Disease Management.

Geneva, Switzerland; 2003.

Most read articles by the same author(s)