Aims

  • To test the feasibility, uptake, and accuracy of a screening strategy — which included pre-screening self-measurement of waist circumference — in order to identify people with type 2 diabetes and pre-diabetes, for a multi-ethnic UK population

  • To investigate the effectiveness of including a tape measure in invitation packs (in a nested randomised controlled trial [RCT])

  • To explore the attitudes of patients and primary care health professionals towards the strategy, in particular relating to its acceptability

Method
Recruitment

  • 11 general practices in Leicestershire, UK

  • Eligibility: patients aged 40–70years (30–70years for people of South Asian and African-Caribbean origin) were identified through practice registers by practice staff

  • Invitations were sent to 1993 eligible patients, in batches following random selection, from their general practice

  • Nested RCT: in eight practices, those invited were randomly selected to receive or not receive a tape measure in their invitation pack

  • All invitations included a patient information sheet that explained the purpose of the MY-WAIST study and details of the screening tests involved

  • All invitations contained a risk-score questionnaire for self-completiona

  • All invitations included the opportunity to respond by returning a brief questionnaire giving feedback about reasons for declining

Screening appointment

  • Patients accepting the invitation for screening were asked to make an appointment at their general practice and to bring with them their completed sheet recording their self-measured waist circumference and risk-score questionnaire

  • 166 patients attended for screening (8% uptake rate)b

  • All screening participants had an oral glucose tolerance test and assessment of fasting lipids, electrolytes, and urine albumin creatinine ratio

  • A waist-circumference measurement was taken by a practice health professional, who was trained in standard operating procedures

  • Weight, height, and blood pressure were also measured, and participants were asked to complete a set of study questionnaires at the screening appointment

  • ↵a The risk-score questionnaire used was a revised version of the Finnish Diabetes Risk Score,10 with an additional question on ethnicity and a revised illustration.

  • ↵b An uptake rate of 2.6% was recorded across three practices serving predominantly South Asian communities. The MY-WAIST study was approved by the LNR REC (reference number: 07/H0402/66).