Aims/hypothesis: The Leicester Practice Risk Score (LPRS) is a tool for identifying those at high risk of either impaired glucose regulation (IGR), defined as impaired glucose tolerance and/or impaired fasting glucose, or type 2 diabetes from routine primary care data. The aim of this study was to determine the yield from the LPRS when applied in two diabetes prevention trials.
Methods: Let's Prevent Diabetes (LPD) and Walking Away from Diabetes (WAD) studies used the LPRS to identify people at risk of IGR or type 2 diabetes from 54 general practices. The top 10% at risk within each practice were invited for screening using a 75 g OGTT. The response rate to the invitation and the prevalence of IGR and/or type 2 diabetes in each study were calculated.
Results: Of those invited 19.2% (n = 3,449) in LPD and 22.1% (n = 833) in WAD attended. Of those screened for LPD 25.5% (95% CI 24.1, 27.0) had IGR and 4.5% (95% CI 3.8, 5.2) had type 2 diabetes, giving a prevalence of any abnormal glucose tolerance of 30.1% (95% CI 28.5, 31.6). Comparable rates were seen for the WAD study: IGR 26.5% (95% CI 23.5, 29.5), type 2 diabetes 3.0% (95% CI 1.8, 4.2) and IGR/type 2 diabetes 29.5% (95% CI 26.4, 32.6).
Conclusions/interpretation: Using the LPRS identifies a high yield of people with abnormal glucose tolerance, significantly higher than those seen in a population screening programme in the same locality. The LPRS is an inexpensive and simple way of targeting screening programmes at those with the highest risk.