Secondary prevention of diabetes through workplace health screening.

BACKGROUND: Workplace health screening offers a unique opportunity to assess individuals for type 2 diabetes mellitus. AIMS: To evaluate the association between workplace diabetes screening, subsequent diagnosis and changes in fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) and body mass index (BMI) among individuals who screened positive for diabetes. METHODS: Employees without a prior diagnosis of diabetes participated in workplace health screening by 45 employers throughout the USA. Individuals screened positive for diabetes based on standard criteria (≥126 mg/dL FPG or ≥6.5% [48 mmol/mol] HbA1c). Diabetes diagnoses were identified after screening using claims-based ICD9-CM diagnosis codes. Discrete-time survival analysis estimated the monthly rate of new diabetes cases after screening, relative to the time period before screening. Paired t-tests evaluated 1-year changes in blood glucose measures and BMI among individuals with positive screenings. RESULTS: Of 22790 participating individuals, 900 (4%) screened positive for diabetes. A significantly greater rate of new diabetes diagnoses was observed during the first month after screening, compared to the 3-month period before screening (odds ratio [OR] 2.65, 95% confidence intervals [CIs] 2.02-3.47). Among 538 individuals with diabetes who returned for workplace screening 1 year later, significant improvements were observed in BMI (mean ± SD = -0.63 ± 2.56 kg/m2, P < 0.001) and FPG levels (mean ± SD = -9.3 ± 66.5 mg/dL, P < 0.01). CONCLUSIONS: Workplace screening was associated with a reduction in the number of undiagnosed employees with diabetes and significant improvement in FPG and BMI at 1-year follow-up.

Expression of Toll-like receptor 4 and beta 1 integrin in breast cancer.

Toll-like receptor (TLR) 4 signaling pathway has been shown to support tumor cell growth in vitro and in vivo. Its stimulation on breast cancer cell lines induces ß1 integrin and promotes tumor invasiveness. However, its role in predicting clinical behavior of tumor is not yet clarified. Therefore, we investigated TLR4 and ß1 integrin expression on 133 primary breast cancer samples by immunohistochemistry and correlated it with overall survival and disease-free survival of patients as well as with clinicopathological characteristics of the tumor. We found higher ß1 integrin expression in invasive lobular cancer in comparison with other tumor types. No significant association of TLR4 and ß1 integrin expression with overall survival or disease-free survival was seen. Therefore, we conclude that expression of these markers is of biological interest but appears to be of little additional use as predictive clinical marker.