COST-EFFECTIVE MODEL OF SCREENING FOR TYPE 2 DIABETES IN THE REPUBLIC OF UZBEKISTAN
Аннотация
Epidemiological studies revealed up to 5-6 undiagnosed cases of type 2 diabetes mellitus (DM2) per 1 registered patient. The late diagnosis of DM2 presents a medical and socio-economic problem. Aim. To identify the most cost-effective, easy-to-use method for regular screening for DM2 in primary care settings in the Republic of Uzbekistan. Material and methods. 4 diabetes screening scenarios differing in the inclusion criteria (age 45 vs age 45 plus arterial hypertension plus obesity), and screening methods (testing for glycemia and/or HbA1c) were studied in urban and rural primary care polyclinics among 2430 people. Results. In primary health care real clinical practice, the most cost-effective and easy-to-follow strategy for active screening for DM2 is testing for random glycemia using a certified glucometer, in any resident aged 45 or older visiting his/her GP for any reason. If test results are intermediate, the person is called again the next day for fasting glycemia testing to confirm the diagnosis. If the test results are normal, the person is given recommendations of healthy lifestyle and re-testing in 1 year. If the test result corresponds to DM, the person is referred to a local endocrinologist.