糖尿病集団検診に関する実験的研究 : 主としてくり返し検査によるスクリーニング基準の検討
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概要
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Diabetes is one of recently increasing diseases. As complete cure of this disease can not be expected, the need for early detection and control of the condition is emphasized and screening test as the first step of mass examination is important for that purpose. All screening tests are faced with the problem of false positive versus false negative. The author had investigated on the postprandial, blood sugar and urine sugar values in men of over forty years of age in a certain factory in Chiba Prefecture in order to study the screening method of diabetes. The blood was taken from the ear-lobe and the sugar value was measured by the method of Hagedorn Jensen. The urine sugar value was measured by Tes Tape. As the first step the urine sugar in 255 men were measured at the end of two hours after the meal of sufficient rice (about 300 grams) and 50 grams of sweetened bean-jelly (32.5 grams as sugar). The urine sugar values in 68 men were above ±. As the second step the blood sugar and urine sugar in 68 men at the end of two hours after the meal of sufficient rice (about 300 grams) were measured repeatedly at about 10 days intervals. The tests of 57 men were carried out three times. As the third step the blood sugar and urine sugar were measured at fasting, one hour, two hours and three hours after the meal of sufficient rice (300 grams + α). Five men as diabetics and nine men as suspected diabetics were determined according to the standard of Diabetes Survey Party and the screening level was discussed mainly depending on the results of the repeated tests, in which the blood sugar and urine sugar values fairly varied and the range of the variation of the former was 4.0 to 45.0. From the view point of lessening mainly the false negative rate, the results were summarized as follows: 1) It is considered to be efficient to increase the quantity of rice over 300 grams at the blood sugar test or to give bean-jelly with sufficient rice at the urine sugar test. 2) It is considered to be efficient that the screening level should be ± at the urine sugar test and should be under 140 mg. per cent (in the neighbourhood of 130 mg. per cent) at the blood sugar test. 3) If the screening level at the blood sugar test is determined to be 140 mg. per cent, it is considered to be necessary that screening test should be repeated two or three times at least to find the majority of borderline cases.