@article{8675241,
  abstract     = {{Background The implementation of population screening and early prevention strategies targeting individuals at high-risk for type 2 diabetes (T2D) seems to be a public health priority. The current work aimed to describe the screening procedure applied in the Feel4Diabetes-study and examine its effectiveness in identifying individuals and families at high risk, primarily for T2D and secondarily for hypertension, among vulnerable populations in low to middle-income countries (LMICs) and high-income countries (HICs) across Europe. Methods A two-stage screening procedure, using primary schools as the entry-point to the community, was applied in low socioeconomic status (SES) regions in LMICs (Bulgaria-Hungary), HICs (Belgium-Finland) and HICs under austerity measures (Greece-Spain). During the first-stage screening via the school-setting, a total of 20,501 parents (mothers and/or fathers) of schoolchildren from 11,396 families completed the Finnish Diabetes Risk Score (FINDRISC) questionnaire, while their children underwent anthropometric measurements in the school setting. Parents from the identified "high-risk families" (n = 4484) were invited to participate in the second-stage screening, including the measurement of fasting plasma glucose (FPG) and blood pressure (BP). In total, 3153 parents participated in the second-stage screening (mean age 41.1 +/- 5.6 years, 65.8% females). Results Among parents who attended the second-stage screening, the prevalence of prediabetes (as defined by impaired fasting glucose; FPG 100-125 mg/dl) and T2D (FPG > 126 mg/dl) was 23.2 and 3.0% respectively, and it was found to be higher in the higher FINDRISC categories. The percentage of undiagnosed T2D among the participants identified with T2D was 53.5%. The prevalence of high normal BP (systolic BP 130-139 mmHg and/ or diastolic BP 85-89 mmHg) and hypertension (systolic BP >= 140 mmHg and/ or diastolic BP >= 90 mmHg) was 14 and 18.6% respectively, which was also higher in the higher FINDRISC categories. The percentage of cases not receiving antihypertensive treatment among the participants identified with hypertension was 80.3%. Conclusion The findings of the current study indicate that the two-stage school and community-based screening procedure followed, effectively identified high-risk individuals and families in vulnerable populations across Europe. This approach could be potentially scalable and sustainable and support initiatives for the early prevention of T2D and hypertension.}},
  articleno    = {{12}},
  author       = {{Manios, Yannis and on behalf of the Feel4Diabetes-study group, [missing] and Mavrogianni, Christina and Lambrinou, Christina-Paulina and Cardon, Greet and Lindström, Jaana and Iotova, Violeta and Tankova, Tsvetalina and Civeira, Fernando and Kivelä, Jemina and Jancsó, Zoltán and Shadid, Samyah and Tsochev, Kaloyan and Mateo-Gallego, Rocío and Radó, Sándorné and Dafoulas, George and Makrilakis, Konstantinos and Androutsos, Odysseas}},
  issn         = {{1472-6823}},
  journal      = {{BMC ENDOCRINE DISORDERS}},
  keywords     = {{physical activity & health,Endocrinology,Diabetes and Metabolism,General Medicine,Screening,School-based,Vulnerable groups,Type 2 diabetes,Hypertension,CHILDHOOD OBESITY,LIFE-STYLE,HYPERTENSION,PREVALENCE,AWARENESS,GUIDELINES,MORTALITY,MELLITUS,OUTCOMES,PEOPLE}},
  language     = {{eng}},
  number       = {{Supplement 1}},
  pages        = {{11}},
  title        = {{Two-stage, school and community-based population screening successfully identifies individuals and families at high-risk for type 2 diabetes : the Feel4Diabetes-study}},
  url          = {{http://dx.doi.org/10.1186/s12902-019-0478-9}},
  volume       = {{20}},
  year         = {{2020}},
}

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