Electronic letters to:

Research:
Claudia Gagnon and Jean-Patrice Baillargeon
Suitability of recommended limits for fasting glucose tests in women with polycystic ovary syndrome
CMAJ 2007; 176: 933-938 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read eLetter] Screening recommendations and impact on intervention
Alun L Edwards   (23 August 2007)

Screening recommendations and impact on intervention 23 August 2007
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Alun L Edwards
University of Calgary

Send letter to journal:
Re: Screening recommendations and impact on intervention

aedwards{at}ucalgary.ca Alun L Edwards

Drs Gagnon and Baillargeon add to the literature showing a discrepancy between fasting and post-challenge glucose values in populations with metabolic disorders. Their conclusion that an OGTT be used for 'screening' in all women diagnosed with PCOS (on clinical criteria) needs to be questioned. A screening test's utility depends on its reliability but also needs to be applicable widely to drive interventions proven to be successful and to be cost-effective. The recommendation for intervention for abnormal glucose tolerance is through lifestyle interventions (with evidence that they are successful). As the majority of the patients in this study were obese with mean BMI of 35 and had clinical features of PCOS it is difficult to see how the diagnosis of abnormal glucose tolerance adds much impetus to the recommendation for strategies to lose weight. Performing repeated OGTT in 6-10% of women of reproductive age would not be cheap; the resources might be better diverted to weight-loss management programs.

Conflict of Interest:

None declared