A Novel Testing Model for Opportunistic Screening of Pre-Diabetes and Diabetes among U.S. Adults

Abstract

ObjectiveThe study aim was to evaluate the performance of a novel simultaneous testing model, based on the Finnish Diabetes Risk Score (FINDRISC) and HbA1c, in detecting undiagnosed diabetes and pre-diabetes in Americans.Research Design and MethodsThis cross-sectional analysis included 3,886 men and women (≥ 20 years) without known diabetes from the U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2010. The FINDRISC was developed based on eight variables (age, BMI, waist circumference, use of antihypertensive drug, history of high blood glucose, family history of diabetes, daily physical activity and fruit & vegetable intake). The sensitivity, specificity, and the receiver operating characteristic (ROC) curve of the testing model were calculated for undiagnosed diabetes and pre-diabetes, determined by oral glucose tolerance test (OGTT).ResultsThe prevalence of undiagnosed diabetes was 7.0% and 43.1% for pre-diabetes (27.7% for isolated impaired fasting glucose (IFG), 5.1% for impaired glucose tolerance (IGT), and 10.3% for having both IFG and IGT). The sensitivity and specificity of using the HbA1c alone was 24.2% and 99.6% for diabetes (cutoff of ≥6.5%), and 35.2% and 86.4% for pre-diabetes (cutoff of ≥5.7%). The sensitivity and specificity of using the FINDRISC alone (cutoff of ≥9) was 79.1% and 48.6% for diabetes and 60.2% and 61.4% for pre-diabetes. Using the simultaneous testing model with a combination of FINDRISC and HbA1c improved the sensitivity to 84.2% for diabetes and 74.2% for pre-diabetes. The specificity for the simultaneous testing model was 48.4% of diabetes and 53.0% for pre-diabetes.ConclusionsThis simultaneous testing model is a practical and valid tool in diabetes screening in the general U.S. population.

A risk‐score model for predicting risk of type 2 diabetes mellitus in a rural Chinese adult population: A cohort study with a 6‐year follow‐up

“…Diabetes, especially type 2 diabetes mellitus (T2DM), has become a major public health problem . In 2014, the International Diabetes Federation estimated that the total number of cases of global diabetes is expected to increase to 592 million by 2035, with the number of Chinese cases increasing to 142.7 million .…”

Metabolic and hormone influences on emotion processing during menopause

“…Higher levels of HbA1c, a measure of long-term glucose homeostasis, were associated with increased activation in the TPO junction, and with lower accuracy, and longer reaction time, at correctly identifying emotionally neutral images. Interestingly, the range of HbA1c values in our sample, and particularly the perimenopausal group, fall near the 5.7% cut-off for pre-diabetes determined by the U. S. National Health and Nutrition Examination Survey (NHANES) (Zhang et al, 2015). When we divided our group into “higher” and “lower” HbA1c levels, relationships between HbA1c and TPO junction activation and reaction time to emotionally neutral images were found to exist only in women with higher HbA1c levels, with mean HbA1c falling within pre-diabetic range.…”

Targeted Screening Reveals High Numbers of Prediabetes and Diabetes Mellitus in Moshi, Tanzania

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