Diabetes Risk Calculator

Heikes, K. E.; Eddy, David M.; Arondekar, Bhakti; Schlessinger, Leonard

doi:10.2337/dc07-1150

Cited by 226 publications

(168 citation statements)

References 17 publications

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“…Questionnaires are inexpensive and some have been reported to provide AROC for diabetes of~0.80 [21], comparable to that of RPG in the present study, with most providing AROC 0.70-0.75 [22]. In our population, the Diabetes Risk Calculator [23] provided AROC 0.70 for diabetes and 0.67 for prediabetes 110 . Such inefficiency has led to greater interest in glycaemic indicators such as HbA 1c [24], which identified retinopathy almost as well as fasting or 2 h postchallenge glucose in a Pima Indian population [25], but in other populations performed less well than fasting glucose in identifying diabetes [26] and was very insensitive in detecting IGT [27], comparable to findings in our study.…”

Section: Discussionsupporting

confidence: 51%

Glucose challenge test screening for prediabetes and undiagnosed diabetes

et al. 2009

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Aims/hypothesis Diabetes prevention and care are limited by lack of screening. We hypothesised that screening could be done with a strategy similar to that used near-universally for gestational diabetes, i.e. a 50 g oral glucose challenge test (GCT) performed at any time of day, regardless of meal status, with one 1 h sample. Methods At a first visit, participants had random plasma and capillary glucose measured, followed by the GCT with plasma and capillary glucose (GCTplasma and GCTcap, respectively). At a second visit, participants had HbA 1c measured and a diagnostic 75 g OGTT. ResultsThe 1,573 participants had mean age of 48 years, BMI 30.3 kg/m 2 and 58% were women and 58% were black. Diabetes (defined by WHO) was present in 4.6% and prediabetes (defined as impaired glucose tolerance [2 h glucose 7.8-11.1 (140-199 mg/dl) with fasting glucose ≤6.9 (125 mg/dl)] and/or impaired fasting glucose with plasma glucose 6.1-6.9 mmol/l [110-125 mg/dl]) in 18.7%. The GCTplasma provided areas under the receiver-operatingcharacteristic curves of 0.90, 0.82 and 0.79 for detection of diabetes, diabetes or prediabetes, and prediabetes, respectively, all of which were higher than GCTcap, random and capillary glucose, and HbA 1c (p<0.02 for all). The perfor- mance of GCTplasma was unaffected by time after meals or time of day, and was better in blacks than whites, but otherwise comparable in men and women, and in groups with differing prevalence of glucose intolerance. GCTplasma screening would cost approximately US$84 to identify one person with previously unrecognised diabetes or prediabetes. Conclusions/interpretation GCT screening for prediabetes and previously unrecognised diabetes would be accurate, convenient and inexpensive. Widespread use of GCT screening could help improve disease management by permitting early initiation of therapy aimed at preventing or delaying the development of diabetes and its complications.

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Section: Discussionsupporting

confidence: 51%

Glucose challenge test screening for prediabetes and undiagnosed diabetes

et al. 2009

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“…Explanatory variables reflect risk factors for diabetes that are common to both NHANES and the constructed population database (see Supplementary Data for predictive model results) (14)(15)(16)(17). We applied the predictive model to the constructed population database to generate individual probabilities of undiagnosed diabetes and prediabetes.…”

Section: Estimating Disease Prevalencementioning

confidence: 99%

The Economic Burden of Elevated Blood Glucose Levels in 2012: Diagnosed and Undiagnosed Diabetes, Gestational Diabetes Mellitus, and Prediabetes

et al. 2014

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OBJECTIVE To update estimates of the economic burden of undiagnosed diabetes, prediabetes, and gestational diabetes mellitus in 2012 in the U.S. and to present state-level estimates. Combined with published estimates for diagnosed diabetes, these statistics provide a detailed picture of the economic costs associated with elevated glucose levels. RESEARCH DESIGN AND METHODS This study estimated health care use and medical expenditures in excess of expected levels occurring in the absence of diabetes or prediabetes. Data sources that were analyzed include Optum medical claims for ∼4.9 million commercially insured patients who were continuously enrolled from 2010 to 2012, Medicare Standard Analytical Files containing medical claims for ∼2.6 million Medicare patients in 2011, and the 2010 Nationwide Inpatient Sample containing ∼7.8 million hospital discharge records. The indirect economic burden includes reduced labor force participation, missed workdays, and reduced productivity. State-level estimates reflect geographic variation in prevalence, risk factors, and prices. RESULTS The economic burden associated with diagnosed diabetes (all ages) and undiagnosed diabetes, gestational diabetes, and prediabetes (adults) exceeded $322 billion in 2012, consisting of $244 billion in excess medical costs and $78 billion in reduced productivity. Combined, this amounts to an economic burden exceeding $1,000 for each American in 2012. This national estimate is 48% higher than the $218 billion estimate for 2007. The burden per case averaged $10,970 for diagnosed diabetes, $5,800 for gestational diabetes, $4,030 for undiagnosed diabetes, and $510 for prediabetes. CONCLUSIONS These statistics underscore the importance of finding ways to reduce the burden of prediabetes and diabetes through prevention and treatment.

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“…We categorized each participant's risk of type 2 diabetes or pre-diabetes using the American Diabetes Association (ADA) Diabetes Risk Test (http://www.diabetes.org/diabetes-basics/prevention/diabetes-risk-test). This validated algorithm uses BMI, age, race, immediate family history of diabetes, and personal history of hypertension or gestational diabetes to categorize respondents as having low, medium, or high risk for type 2 diabetes (Heikes et al 2008). …”

Section: Measurementsmentioning

confidence: 99%

Genetic susceptibility testing for chronic disease and intention for behavior change in healthy young adults

et al. 2013

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Genetic testing for chronic disease susceptibility may motivate young adults for preventive behavior change. This nationally representative survey gave 521 young adults hypothetical scenarios of receiving genetic susceptibility results for heart disease, type 2 diabetes, and stroke and asked their (1) interest in such testing, (2) anticipated likelihood of improving diet and physical activity with highand low-risk test results, and (3) readiness to make behavior change. Responses were analyzed by presence of established disease-risk factors. Respondents with high phenotypic diabetes risk reported increased likelihood of improving their diet and physical activity in response to highrisk results compared with those with low diabetes risk (odds ratio (OR), 1.82 (1.03, 3.21) for diet and OR, 2.64 (1.24, 5.64) for physical activity). In contrast, poor baseline diet (OR, 0.51 (0.27, 0.99)) and poor physical activity (OR, 0.53 (0.29, 0.99)) were associated with decreased likelihood of improving diet. Knowledge of genetic susceptibility may motivate young adults with higher personal diabetes risk for improvement in diet and exercise, but poor baseline behaviors are associated with decreased intention to make these changes. To be effective, genetic risk testing in young adults may need to be coupled with other strategies to enable behavior change.

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Diabetes Risk Calculator

Cited by 226 publications

References 17 publications

Glucose challenge test screening for prediabetes and undiagnosed diabetes

Glucose challenge test screening for prediabetes and undiagnosed diabetes

The Economic Burden of Elevated Blood Glucose Levels in 2012: Diagnosed and Undiagnosed Diabetes, Gestational Diabetes Mellitus, and Prediabetes

Genetic susceptibility testing for chronic disease and intention for behavior change in healthy young adults

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