FINDRISC IN SWEDENThe feasibility of the questionnaire in a Swedish population

1,2,3M.I. Hellgren, 3P. Friberg, 4M. Petzold, 1C. Björkelund, 4H. Wedel, 5P-A Jansson, 1,6U. Lindblad1Department of Public Health and Community Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, 2Hentorp Health Care Centre, Skövde, 3Skaraborg Primary Care R&D unit,Sklövde, 4Nordic School of Public Health, Gothenburg, 5The Wallenberg laboratory at Sahlgrenska University Hospital, University of Gothenburg, 6Skaraborg Institute, Skövde, all located in Sweden

BackgroundTo detect individuals at risk to develop diabetes is of great importance as there are efficient life-style interventions available to prevent conversion to T2D in individuals with IGT. The efficiency of life-style intervention in individuals with IFG is uncertain. To distinguish between IFG and IGT is therefore of great importance. FINDRISC is a screening instrument developed in Finland, as a simple way to detect individuals at high risk based of well known risk factors (age, BMI, waist circumference, physical activity, heredity, known hypertension, former high blood sugar, and fruit intake). The score reaches from 0 to 26 points, and ≥15 is considered high.

AimTo evaluate FINDRISC as a screening tool in a Swedish population, and in particular to identify individuals with IGT.

MethodThe questionnaire was sent to a geographically defined population of 6673 individuals 35-75 years old. They were all encouraged to return the completed questionnaire to the health care centre (HCC). Those with a score ≥15 were asked to come to the HCC to have their blood glucose examined, and to have an OGTT with a standard 75 g glucose load made. Current WHO criteria were used to define diabetes, IFG, and IGT, respectively.

ResultsScreening outcome is summerized in the flow chart, and tables 1-2. Participation rate was 56%, and of 334 subjects (9%) with a score ≥15, 30 had IGT (16%). In all 102 individuals (56%) had diabetes, IGT or IFG (AGT).

ConclusionsFINDRISC is an efficient tool to identify individuals with abnormal glucose tolerance (AGT). In our Swedish population more than half of the individuals with a risk score ≥ 15 had AGT and of those the majority had IFG. Preventive strategies for IFG need to be developed.

Correspondence to Dr. Margareta Hellgren margareta.leonardsson-hellgren@vgregion.se

Flow chart

3802 ( 56%) subjectsreturned the questionnaire

The questionnaire was sent to a targetpopulation of 6773 individuals

334 (9%) had a high risk score (≥15)

183 (55%) were examined with OGTT

Diabetes 21 (12%)

IFG 51 (28%)

NGT 81 (43%)

IGT/IFG9 (5%)

Table 1. Characteristics of the recent study populations on FINDRISC in Finland* and in Sweden.

FinlandMen

n=1349

SwedenMen

n=1807

FinlandWomenn=1617

SwedenWomenn=1988

m (SD) n (SD) n (SD) n (SD)

Age, years 58 (8) 56 (12) 57 (8) 55 (12)

FINDRIC score 9 (4) 8 (4) 10 (5) 8 (5)

Score ≥15 (%) 12 8 16 9

Table 2. WHO categories of glucose metabolism in Individuals with a riskscore ≥15 In the Swedish sample.

Menn=76n (%)

Womenn=107n (%)

NGT 29 (38) 52 (49)

AGT 47 (62) 55 (51)

Screen detected DM 11 (15) 10 (9)

IGT 10 (13) 11 (10)

IFG 22 (29) 29 (27)

IGT and IFG 4 (5) 5 (5)

* Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome. Saaristo T, Peltonen M, Lindström J, Saarikoski L, Sundvall J, Eriksson JG, Tuomilehto J. Diab Vasc Dis Res. 2005 May;2(2):67-72.

NGT; normal glucose tolerance, IGT; impaired glucose tolerance, IFG; impaired fasting glucoseAGT: abnormal glucose tolerance (IGT and IFG and DM)

IGT 21 (12%)