The impact of screening for Type 2 diabetes in siblings of patients with established diabetes
Article first published online: 31 OCT 2003
Volume 20, Issue 12, pages 996–1004, December 2003
How to Cite
Farmer, A. J., Doll, H., Levy, J. C. and Salkovskis, P. M. (2003), The impact of screening for Type 2 diabetes in siblings of patients with established diabetes. Diabetic Medicine, 20: 996–1004. doi: 10.1046/j.1464-5491.2003.01042.x
- Issue published online: 24 NOV 2003
- Article first published online: 31 OCT 2003
- Accepted 30 April 2003
Background Targeted screening for Type 2 diabetes has been proposed as a method of identifying people with, or at risk of, the disease in order to implement preventive care.
Aim To assess the changes in anxiety, well-being, and cognitions associated with screening for Type 2 diabetes in people at increased risk of diabetes after 1 year; and to identify potential predictors of increased anxiety and lower well being over this period.
Design and setting One-year follow up of a cohort of non-diabetic siblings of those with Type 2 diabetes registered with general practitioners in Oxfordshire and Northamptonshire who were identified for participation in a programme to undertake sib-pair genetic analysis.
Methods Potential families were selected through identification of people with Type 2 diabetes. Family members aged 35–74 years, who did not have diabetes and who were willing to participate in the study, completed measures before receiving the results of a fasting plasma glucose test, and 1 year later. Measures included the Spielberger State Anxiety Scale-short form (SSAI-SF), the Well-Being Questionnaire 12 item scale (WBQ-12), and measures of cognitions about developing diabetes. The Health Anxiety Inventory (HAI) was completed before receiving the results of the tests to assess its relationship with anxiety at 1 year.
Results A cohort of 431 individuals was identified, of whom 328 (76%) returned fully completed WBQ scales both initially and at 1 year. State anxiety measured with the SSAI-SF fell from 34.5 (95% CI 33.4–35.6) to 32.3 (31.2–33.4) at 1 year (P < 0.0001). Mean WBQ-12 scores rose (i.e. improved) from 26.8 (26.0–27.4) to 27.4 (26.7–28.1) (P = 0.008). SSAI-SF and WBQ-12 mean scores over 1 year did not differ between participants receiving a normal or an at-risk test result. However, those receiving an at-risk test result were more likely, at 1 year, to consider themselves at increased likelihood of developing diabetes (P < 0.001) and to report thinking about what it would be like to develop diabetes (P = 0.006). A score in the upper tertile of the initial HAI was associated with an increased level of anxiety at 1 year (adjusted odds ratio 2.0, 95% CI 1.2–3.4, P = 0.006).
Conclusions There is no evidence that an ‘at-risk’ test result leads to sustained anxiety or reduced well being at 1 year compared with those receiving a normal test result. However, further studies are required to clarify levels of anxiety prior to screening to assess the overall impact of the process.
Diabet. Med. **, ***–*** (2003)