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The aim of this study is to develop strategies to screen diabetic subjects with isolated postload hyperglycemia (IPH) in Chinese population. We included 1175 adult subjects who did not report diabetes were included. Diabetes was diagnosed by oral glucose tolerance tests. IPH was defined as fasting plasma glucose (FPG)<7 mmol/l and 2-hour post-load plasma glucose (2hPG) greater than 11.1 mmol/l. Using FPG criteria, only 59.8% of diabetic subjects were not identified, showing a poor agreement between FPG and 2hPG criteria (kappa 0.294). Age, FPG, total cholesterol, triglycerides, blood pressure, body mass index, HbA1c and medication for hypertension were associated factors for IPH. Four scores were constructed using all these factors, age and blood test results, age and HbA1c, and data from non-invasive examinations, respectively. The area under the ROC curve were 0.9296(95%CI 0.8948-0.9643), 0.9111(95%CI 0.8713-0.9508), 0.8902(95%CI 0.8341-0.9646), 0.8924(95%CI 0.7835-0.8753), and 0.8654(95%CI 0.7963-0.9345) for score 1, 2, 3, 4, and HbA1c, respectively. The sensitivity of all four risk scores to detect IPH was better than that of impaired fasting glucose (IFG). The sensitivity and specificity of HbA1c at cutoff 6.2% for detecting IPH was also better than that of IFG. In conclusion, the risk scores and HbA1c are useful to identify subjects with undiagnosed IPH, with better performance than IFG.
The oral health of children with disability is often not as good as that of other children. In view of improving their oral health, this study aims to explore the utilization of fluoride varnish services among children with disability in Taiwan and its relevant influencing factors. With children under the age of 5 as subjects, this study is conducted based on the database of Ministry of the Interior, Executive Yuan, ROC in 2008, coupled with information gathered between 2006 and 2008 on preventive health care and health insurance from the Bureau of Health Promotion and the National Health Research Institute, respectively. In addition to descriptive statistics and bivariate analysis, this study examined the factors determining the use of fluoride varnish with logistic regression analysis. Research revealed that fluoride varnish is used by up to 9.84% of children with disability; the use increases with age and decreases with increased level of disability, but is remarkably higher in those with catastrophic illness/injury. The probability of fluoride varnish use is lower among those living in areas of lower urbanization (levels 5-7) and higher among those whose parents have higher premium-based monthly salaries. Recommendations include (1) providing a differential pricing scheme for fluoride varnish based on the level of disability of the child, (2) promoting proactively among dentists to carry out regular fluoride varnish in rural areas and collaboration with pediatricians to provide convenient services and (3) targeting families in low socioeconomic brackets, improving knowledge of fluoride varnish.