| OBJECTIVEType 2 diabetes(T2DM) is resulted from both genetic and environmental factors such as overweight, obesity, physical inactivity, sedentary behavior, and unhealthy dietary habits. According to the latest data released by WHO in 2004, currently the diabetics number is about 194 million, and about 366million adults worldwide will have diabetes by the year 2030. DM, particularly T2DM has a high prevalence rate in the world along with the development of global industrialization and the change of life style. It has become an serious public health challenge for developing countries, especially in Asia.Waitan community of Shanghai locates the center position of Shanghai, we select this community to carry out an epidemiological investigation of T2DM to study its prevalence, risk factors, awareness rates and complications for the prevention and control of this disease in this community. So as to develop a simple, economical and helpful method to identify people for undiagnosed diabetes.MethodsThe cluster random sampling method was used to select the study participants and thus four areas from eleven resident areas was choosen as the study site in Waitan community. We conducted an epidemiological investigation of type 2 diabetes in residents age over 45. Data was collected by questionnaire review, anthropometric measurements and laboratory measurements. Cross-sectional study and case-control study were used to investigate awareness rate, prevalence, risk factors and complications of T2DM in this community. Statistic methods such as t test, ANOVA, chi-square test, correlation analysis, trend test, multiple regression and logistic regression analysis were also employed to analyze the data.RESULTS1. Age-standardized prevalence rates of IFG, IGT and T2DM to the 2000 China population were 1.66% 7.21%和10.42%,respectively. 144 type 2 diabetics were found in Waitan community, where 123 were former cases and the 20 cases were newly diagnosed. The awareness rate was 86.11%.2. The prevalence rates for IFG, IGT, and T2DM of sex, different age groups, education levels, hyperpiesia history or not, coronary heart disease history or not, cerebral apoplexy history or not, hyperlipemia history or not, diabetic family history, druggery history were significant (P<0.05).3. The univariate unconditional logistic regression analysis showed that age, BMI, Waist circumference, hyperpiesia history, coronary heart disease history, cerebral apoplexy history, hyperlipemia history, diabetic family historyand taking diuretic medicine for a long time were significant risk factors for T2DM. However, the multivariable unconditional logistic regression analysis showed that diabetic family history, hyperpiesia history, hyperlipemia history and Waist circumferencewere significant independent risk factors for T2DM.4. Based on an epidemiological survey of T2DM in the general population, two groups were selected to develop a screening method on risk factors to identify people at increased risk for undiagnosed diabetes. Logistic regression analysis on the original data of group one was carried out to screen the main risk factors of diabetes. The score of the variables was determined based on the OR value and the aggregate score was used to predict the risk of undiagnosed diabetes. Both validity and effectiveness of the method were evaluated in group two. Results showed that the risk of having diabetes in the population increased along with aggregate scores of the method. Trend x~2 test showed statistical significance(p< 0.001).When the threshold value was set up at 8, both sensitivity and specificity for identifying undiagnosed diabetes were 62.80% and 71.89%.CONCLUSION1. Prevalence rates of IGT and T2DM in every age stage are higher in the Waitan community than the provincial and national date, which suggests that more aggressive preventive measures should be initiated in this community.2. The awareness rate of T2DM is satisfying, which indicate carrying out health education and strengthening health protection in the community are as important as the treat of diabetes.3. Age, BMI, Waist circumference, hyperpiesia history, coronary heart disease history, cerebral apoplexy history, hyperlipemia history, diabetic family history and taking diuretic medicine for a long time are major risk factors of T2DM. However, diabetic family history, hyperpiesia history, hyperlipemia history and Waist circumference were significant independent risk factors for T2DM.4. The screening method is simple, economical and helpful to obtain a satisfactory response fate , which used for health education and to indicate people or community at high risk for potential diabetes. Consequently it was predicted that the method could serve as an effective and useful tool for mass screening of DM.
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