JMIR Publications

ABSTRACT

Background:

Type 2 diabetes (T2D) remains one of the most underdiagnosed chronic conditions worldwide, despite its major contribution to cardiovascular and metabolic morbidity. In 2024, an estimated 589 million adults were living with diabetes globally, more than 90% of whom had T2D, and prevalence is projected to reach 853 million by 2050. In France, approximately 4.1 million adults are affected, and nearly one in four individuals with diabetes remain undiagnosed. Early detection is therefore essential to prevent complications. Workplace-based prevention strategies offer an opportunity to enhance early detection, particularly among employed adults with limited access to regular medical screening. In France, the Union Prévention Santé pour la Fonction publique (UROPS) has implemented a systematic glucose-screening program for civil servants to identify individuals at risk of T2D or prediabetes. Given that the French public service includes 5.7 million workers—around one in five of the national workforce—this setting provides a unique opportunity to reach large, diverse, and often underserved segments of the adult population.

Objective:

Objective:

This study aimed to assess the effectiveness of a systematic diabetes screening program as a preventive public health measure, by determining the rate of newly detected diabetes cases and characterizing associated cardiometabolic risk factors within a large population of French public-sector employees.

Methods:

A retrospective observational study was conducted using data from a glucose screening program between January 2022 and February 2025. Participants with postprandial blood glucose >1.40 g/L were included in a follow-up cohort. Sociodemographic, clinical, and biological data were collected. Comparisons were performed using χ² or Fisher’s exact test for categorical variables and Student’s t-test for continuous variables (R software, v4.3.3; significance p<0.05). Analyses were restricted to complete cases to ensure the robustness of comparisons.

Results:

Among 16,785 screened participants, 981 (5.8%) had post-prandial glucose >1.40 g/L, and 134 met eligibility criteria for the follow-up cohort. Participants were 59.5% women and 40.5% men, with a mean age of 51.3 ± 8.9 years. Overall, 37.6% were overweight, 25.6% were obese, 61.6% reported insufficient physical activity, and 63.2% had a family history of diabetes. Of the 134 eligible individuals, 70 (52.2%) completed medical follow-up, and 9 (12.9%) received a confirmed diagnosis of T2D. Newly diagnosed individuals were predominantly male (77%, p<0.05) and more likely to be overweight or obese (88%, p<0.05). No significant differences in age, sex, or BMI were observed between participants who completed follow-up and those lost to follow-up.

Conclusions:

Systematic glucose screening in an occupational or social health context effectively identifies individuals at risk of diabetes or prediabetes. The results support the integration of such programs into preventive health strategies to enhance early detection and reduce long-term complications. Additional larger prospective or randomized studies are warranted to confirm their long-term impact on diagnosis, care engagement, and cardiometabolic outcomes.