Type 2-diabetes - Sundhedsstyrelsen

H The majority of published studies are based on other countries and other
health systems than the Danish, which limits their generality. Moreover,
cultural factors must be presumed to be of significance for the psychological
and social consequences.
Organisation
H Diagnosis and treatment facilities exist in both the primary sector and in
special outpatient clinics. The frequent and close patient contact in general
practice suggests that the activity should primarily be assigned to general
practice, but there is a lack of studies that document that intensive case
finding (opportunistic screening) can actually be carried out in general
practice. If general practices are to find the time and resources for such
an activity, an analysis should be made of whether other activities will
have to be stopped because of it (due to the limited resources and limited
time in general practice).
H Based on experience from other screening programmes there is reason to
believe that screening can be carried out in general practice provided that
relevant monitoring systems are established to monitor the screening activities
(5).
H If the decision is made to implement screening or more active and systematic
case finding in general practice, consideration should be given to how
this can best be coordinated with other screening and case finding activities,
especially within the cardiovascular area, e.g. screening for raised
blood pressure (hypertension) and raised blood lipids (dyslipidemia) (5).
Economic aspects
H Based on the information available it is not possible to determine whether
screening for Type 2 diabetes in Denmark will be cost-effective.
H A single mass screening round of all Danes aged 40-70 years is estimated
to cost approx. DKK 140 million and identify 20-40,000 Type 2 diabetes
patients. The cost per Type 2 diabetes case detected is estimated to be
DKK 3,500-7,000 in the first screening round, but will be up to approx.
six-fold higher in subsequent screening rounds.
H A single opportunistic screening of the same age group over a 3-year
period is estimated to cost DKK 31-63 million and identify between
16,000 and 65,000 Type 2 diabetes patients. The cost per Type 2 diabetes
case detected is estimated to be in the order DKK 1000-1.900 in the first
3-year screening round. It is not possible to calculate corresponding figures
for subsequent opportunistic screening rounds.
H Based on the available foreign modelling analyses it is expected that screening
of a younger group, for example persons aged 25-44, will be considerably
more cost-effective than screening of the 40-70 age group.
The Project Group’s recommendations on screening for Type 2 diabetes
H General population screening for Type 2 diabetes is not recommended due
to the associated costs and the uncertainty about a treatment effect (B).
H Treatment has a documented effect in patients with clinical symptoms,
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