PMID- 23485494 OWN - NLM STAT- MEDLINE DCOM- 20130828 LR - 20140731 IS - 2046-9055 (Electronic) IS - 2046-9047 (Linking) VI - 33 IP - 1 DP - 2013 Feb TI - Screening for diabetes in schoolchildren in Trinidad, West Indies. PG - 37-41 LID - 10.1179/2046905512Y.0000000032 [doi] AB - BACKGROUND: Although the epidemic of diabetes in adults is well established and documented, information on the epidemiology of type 2 diabetes mellitus (T2DM) in children and adolescents in Trinidad and Tobago is limited. Anecdotal reports suggest an increase in children and especially adolescents with T2DM amongst clinic attendees. OBJECTIVE: To assess the prevalence of diabetes mellitus in schoolchildren screened by mass urinary testing in Trinidad and to determine the effectiveness and cost-effectiveness of this screening method. DESIGN AND METHODS: During January to June 2009, a cross-sectional survey was undertaken in schoolchildren aged 5-17 years, in the island of Trinidad only. Children were instructed to collect an early-morning, pre-breakfast urine sample at home and to bring it to school for testing for glycosuria. Those with an initially positive result underwent a second urine test. Those with two consecutively positive urine tests were invited to undertake an oral glucose tolerance test. RESULTS: 67,000 (53.6%) children from a school-age population of 125,000 were screened. Twenty-three were found to have persistent glycosuria and 21 agreed to undergo an oral glucose tolerance test. Eight fulfilled the American Diabetes Association's criteria for diabetes and five for pre-diabetes. Of the eight with confirmed diabetes (aged 7-18 years), one (male, age 12 years) was slim and ketotic and required insulin for control. Of the other seven, five were overweight (three females, two males) with a BMI >85th per centile and two females were obese (BMI >95th per centile). Five children (four females, one male) aged 12-14 years were diagnosed as pre-diabetic. There is a prevalence of 10.4/100,000 schoolchildren with T2DM, and 7.5/100,000 with impaired glucose intolerance among schoolchildren in Trinidad. Urine screening had a positive predictive value (PPV) of 65% for detecting T2DM in schoolchildren. The cost of screening 67,000 children was US$55,080, a per capita cost of US$7000, representing a 63% saving. CONCLUSION: Despite the low PPV of urine glucose testing, our data support the view that mass screening of schoolchildren in Trinidad for T2DM is both feasible and cost-effective. FAU - Batson, Yvonne Ann AU - Batson YA AD - Departments of Clinical Medical Sciences, The University of the West Indies, Mount Hope, Trinidad and Tobago. flemtt@yahoo.com FAU - Teelucksingh, Surujpal AU - Teelucksingh S FAU - Maharaj, Rohan AU - Maharaj R FAU - Singh, Virendra AU - Singh V FAU - Balkaran, Sasha AU - Balkaran S FAU - Cockburn, Brian AU - Cockburn B LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Paediatr Int Child Health JT - Paediatrics and international child health JID - 101582666 SB - IM CIN - Paediatr Int Child Health. 2013 Feb;33(1):3. PMID: 23485488 MH - Adolescent MH - Child MH - Costs and Cost Analysis MH - Cross-Sectional Studies MH - Diabetes Mellitus, Type 2/*epidemiology MH - Female MH - Glucose Tolerance Test MH - Glycosuria/diagnosis MH - Humans MH - Male MH - Mass Screening/economics/methods MH - Prevalence MH - Trinidad and Tobago/epidemiology EDAT- 2013/03/15 06:00 MHDA- 2013/08/29 06:00 CRDT- 2013/03/15 06:00 PHST- 2013/03/15 06:00 [entrez] PHST- 2013/03/15 06:00 [pubmed] PHST- 2013/08/29 06:00 [medline] AID - 10.1179/2046905512Y.0000000032 [doi] PST - ppublish SO - Paediatr Int Child Health. 2013 Feb;33(1):37-41. doi: 10.1179/2046905512Y.0000000032.