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

^aThe 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.

^bAn 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).