Secondary prevention of diabetes through workplace health screening

V. Bali, I. Yermilov, A. Koyama, A. P. Legorreta

Research output: Contribution to journalArticle

Abstract

Background: Workplace health screening offers a unique opportunity to assess individuals for type 2 diabetes mellitus. Aims: To evaluate the association between workplace diabetes screening, subsequent diagnosis and changes in fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) and body mass index (BMI) among individuals who screened positive for diabetes. Methods: Employees without a prior diagnosis of diabetes participated in workplace health screening by 45 employers throughout the USA. Individuals screened positive for diabetes based on standard criteria (≥126 mg/dL FPG or ≥6.5% [48 mmol/mol] HbA1c). Diabetes diagnoses were identified after screening using claims-based ICD9-CM diagnosis codes. Discrete-time survival analysis estimated the monthly rate of new diabetes cases after screening, relative to the time period before screening. Paired t-tests evaluated 1-year changes in blood glucose measures and BMI among individuals with positive screenings. Results: Of 22790 participating individuals, 900 (4%) screened positive for diabetes. A significantly greater rate of new diabetes diagnoses was observed during the first month after screening, compared to the 3-month period before screening (odds ratio [OR] 2.65, 95% confidence intervals [CIs] 2.02-3.47). Among 538 individuals with diabetes who returned for workplace screening 1 year later, significant improvements were observed in BMI (mean ± SD = -0.63 ± 2.56 kg/m2, P < 0.001) and FPG levels (mean ± SD = -9.3 ± 66.5 mg/dL, P < 0.01). Conclusions: Workplace screening was associated with a reduction in the number of undiagnosed employees with diabetes and significant improvement in FPG and BMI at 1-year follow-up.

Original languageEnglish
Pages (from-to)610-616
Number of pages7
JournalOccupational medicine (Oxford, England)
Volume68
Issue number9
Early online date31 Oct 2018
DOIs
Publication statusPublished - Dec 2018

Keywords

  • Diabetes
  • secondary prevention
  • workplace health screening

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