Screening for pre-diabetes and diabetes in the workplace.

Background: Diabetes is an increasingly prevalent and burdensome disease in working populations. In settings with established occupational medical programmes, there may be opportunities to intervene in a positive way to reduce the burden of this disease.

Aim: To integrate diabetes screening and prevention into an existing occupational medical programme.

Methods: Screening to detect potential cases of pre-diabetes and diabetes was conducted in a large working population using differing criteria to define risk groups over a 2-year period. Classification of new cases was based on fasting plasma glucose, random plasma glucose or oral glucose tolerance test (OGTT).

Results: Among 13,086 employees screened via fasting or random glucose, there were 96 diabetes and 650 pre-diabetes cases detected. Among high-risk employees, 20 new cases of pre-diabetes and 8 cases of diabetes were detected in 84 employees assessed by OGTT. The percentage of employees with new findings increased with increasing age (2.3%, under age 40 compared to 11.4% for age 50 years and above) and body mass index (2.6, 6.1 and 11.4% among normal weight, overweight and obese employees, respectively).

Conclusions: Given the likely magnitude of unrecognized diabetes and pre-diabetes cases, further interventions are being implemented targeting all employees and not just those who require routine occupational medical examinations.