Background: The growing prevalence of type
2 diabetes mellitus poses a massive problem
in the day-to-day work environment. Effective
screening for diabetes is therefore an important
part of the occupational medical screening
programme. However, acceptance of the
oral glucose tolerance test (OGTT) - the gold
standard for diagnosing diabetes mellitus - is
only limited. The aim of our study was to develop
a cost-effective and attractive testing
procedure (a test breakfast with a defined level
of glucose) that can be well-standardized and
is widely accepted in the workplace.
Methods: As part of the workplace health
promotion programme, a test breakfast with
76.8 g of glucose equivalents and an OGTT
were provided in a cross-over study of healthy
volunteers. The acceptance of the test breakfast
compared with OGTT was recorded in a
questionnaire, and blood glucose and insulin
levels were measured in a fasting state as well
as after 60 and 120 minutes after the meal.
Results: A total of 65 volunteers took part
in the study. All the volunteers considered
diabetes to be a serious illness. Only 3.1 %
were of the opinion that an OGTT could be
well-integrated into the work environment as
a screening test, and 90.8 % of respondents
preferred a test breakfast to the OGTT. The
fasting blood glucose levels were 96.9 mg/dl
before the test breakfast and 94.8 mg/dl before
the OGTT. Blood glucose levels rose to
118.8 mg/dl 60 minutes after the breakfast
and to 115.5 mg/dl after the OGTT, and fell to
91.8 mg/dl and 96.8 mg/dl respectively after
120 minutes. Insulin secretion was also comparable
at all three times in both tests.
Conclusion: Providing a standardized test breakfast
was seen as a more attractive test option
and, in our sample, produced values that were
comparable with the OGTT in terms of the glucose
and insulin response. A test breakfast is a
suitable first screening measure to increase the
acceptance of diabetes screening in occupational
medical programmes and thus can improve
the options for early detection of diabetes.
