Mass Screening for Diabetes in a Metropolitan Area Using Finger Blood Glucose after a Carbohydrate Load

Abstract

New technical methods and instruments have made possible large scale screening for diabetes. A palatable, refreshing, carbonated drink, containing the equivalent of 75 gm. of glucose, was developed which makes possible uniform carbohydrate administration without nausea. Portable, automatic, analytical instruments, capable of rapid and accurate determination of glucose by a ferricyanide reduction method, were designed and built. Only .075 ml. of blood, readily obtainable from a finger prick, was required. The result was available in seven minutes, each machine being capable of forty analyses per hour. The equipment was incorporated into mobile units for testing in a community, or setting up in industrial plants. Confirmatory carbohydrate tolerance tests were done whenever possible on all individuals having capillary blood glucose levels above 140 mg. per 100 ml., two hours after the carbohydrate drink. In a completed Pilot Study, 8,790 individuals were screened, with 709 initially positive; 560 individuals returned for carbohydrate tolerance tests, and of these 407 had abnormal curves, for atotal over-all incidence of 4.5 per cent. An advantage of this method is that every individual screened has had, in effect, two carbohydrate tolerance tests before being referred to his physician.