Nonlaboratory-Based Risk Assessment Algorithm for Undiagnosed Type 2 Diabetes Developed on a Nation-Wide Diabetes Survey

Abstract

OBJECTIVETo develop a New Chinese Diabetes Risk Score for screening undiagnosed type 2 diabetes in China.RESEARCH DESIGN AND METHODSData from the China National Diabetes and Metabolic Disorders Study conducted from June 2007 to May 2008 comprising 16,525 men and 25,284 women aged 20–74 years were analyzed. Undiagnosed type 2 diabetes was detected based on fasting plasma glucose ≥7.0 mmol/L or 2-h plasma glucose ≥11.1 mmol/L in people without a prior history of diabetes. β-Coefficients derived from a multiple logistic regression model predicting the presence of undiagnosed type 2 diabetes were used to calculate the New Chinese Diabetes Risk Score. The performance of the New Chinese Diabetes Risk Score was externally validated in two studies in Qingdao: one is prospective with follow-up from 2006 to 2009 (validation 1) and another cross-sectional conducted in 2009 (validation 2).RESULTSThe New Chinese Diabetes Risk Score includes age, sex, waist circumference, BMI, systolic blood pressure, and family history of diabetes. The score ranges from 0 to 51. The area under the receiver operating curve of the score for undiagnosed type 2 diabetes was 0.748 (0.739–0.756) in the exploratory population, 0.725 (0.683–0.767) in validation 1, and 0.702 (0.680–0.724) in validation 2. At the optimal cutoff value of 25, the sensitivity and specificity of the score for predicting undiagnosed type 2 diabetes were 92.3 and 35.5%, respectively, in validation 1 and 86.8 and 38.8% in validation 2.CONCLUSIONSThe New Chinese Diabetes Risk Score based on nonlaboratory data appears to be a reliable screening tool to detect undiagnosed type 2 diabetes in Chinese population.

Dietary Information Improves Model Performance and Predictive Ability of a Noninvasive Type 2 Diabetes Risk Model

“…Many noninvasive risk models have been developed to predict the risk of type 2 diabetes [1–11]. Some of them have been developed for Asians [6–11], which also can be adapted to the setting and purpose of our study.…”

“…Some of them have been developed for Asians [6–11], which also can be adapted to the setting and purpose of our study. Most of these risk models included the following classic risk factors: age, gender, BMI, WC, family history of diabetes, hypertension, sport time, smoking and alcohol consumption.…”

“…A number of noninvasive diabetes risk models have been developed to predict the risk of developing type 2 diabetes and to identify high-risk individuals [1–11]. The advantages of a noninvasive diabetes risk model are its lower cost and greater convenience compared with the blood glucose test.…”

“…This finding suggested that these diabetes risk models that were developed for Caucasian populations may be limited when applied to an Asian population. However, very few diabetes risk models have been developed for the Asian population [6–11]. Furthermore, most of the risk models developed for Caucasians did not include dietary predictors, and there is no diabetes risk model including dietary predictors for Asians.…”

Prediction of gestational diabetes mellitus in the Born in Guangzhou Cohort Study, China

“…13 The risk score for each participant was then calculated by multiplying the weight and the value for each factor and adding up the individual scores to obtain the total score. For each factor, a weight was obtained by multiplying the β-coefficient from the multivariate logistic regression model by 10 and then rounding it to the nearest integer.…”