Transculturalizing Diabetes Prevention in Latin America

Nieto-Martínez, Ramfis; González-Rivas, Juan P.; Aschner, Pablo; Barengo, Noël C.; Mechanick, Jeffrey I.

doi:10.1016/j.aogh.2017.07.001

Cited by 26 publications

(34 citation statements)

References 47 publications

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“…On the other hand, a random sample of 521 participants recruited from the EVESCAM study showed that a LA-FINDRISC >10 had a sensitivity of 63% and a specificity of 61% for predicting glucose metabolism impairment, with an AUC of 0.68 [7]. …”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, LA-FINDRISC was also evaluated in two primary care centers in Uruguay, where a total of 109 subjects were included and it was shown that a score >14 had a sensitivity of 70% and a specificity of 66% for predicting unknown diabetes or prediabetes [7]. Although the cutoff point found in this study is similar to ours, the differences in sensitivity may be due to the fact that the subjects evaluated in Uruguay had been enrolled from clinical centers and therefore are not necessarily representative of the general population.…”

Section: Discussionmentioning

confidence: 99%

“…However, this questionnaire was designed for the population of Finland. Thus, it needs to be validated in other populations [7]. …”

Section: Discussionmentioning

confidence: 99%

“…By replacing the original cutoff point of waist circumference (WC) with the Latin American cutoff point in a Colombian (Bogotá) and Venezuelan (Barquisimeto) clinical setting, the modified FINDRISC (LA-FINDRISC) demonstrated a similar performance in identifying impaired glucose regulation in men and a better discriminative power in women than the original FINDRISC [8, 9]; however, the optimal cutoff value for predicting glucose regulation disorders may be different depending on the population under study, even within the same country [7]. As there are no previous studies that have evaluated the usefulness of LA-FINDRISC as a screening tool for glucose regulation disorders in a population of the southeastern region of Venezuela, we decided to conduct the present study, the aim of which was to evaluate LA-FINDRISC as a screening tool for people with glucose metabolism disorder in Ciudad Bolívar, Venezuela.…”

Section: Introductionmentioning

confidence: 99%

“…The Finnish Diabetes Risk Score (FINDRISC) is one of the most efficient and widely used screening tools to detect new cases of T2DM [6]. However, FINDRISC needs to be validated in populations other than the original Finnish population for which it was developed, in order to determine performance attributes (e.g., sensitivity and specificity) [7]. …”

Section: Introductionmentioning

confidence: 99%

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FINDRISC Modified for Latin America as a Screening Tool for Persons with Impaired Glucose Metabolism in Ciudad Bolívar, Venezuela

et al. 2019

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Objective: The Finnish Diabetes Risk Score (FINDRISC) includes anthropometric, metabolic, and lifestyle factors that predict type 2 diabetes mellitus. The objective of this study was to evaluate the FINDRISC modified for Latin America (LA-FINDRISC) as a screening tool for persons with impaired glucose metabolism in Ciudad Bolívar, Venezuela. Methods: Subjects aged between 18 and 70 years of both sexes without known diabetes were invited to participate. After informed consent, they were screened with the LA-FINDRISC questionnaire and then given an oral glucose tolerance test, using the American Diabetes Association criteria for diagnosis. To obtain the cutoff point of LA-FINDRISC for predicting impaired glucose regulation, a receiver operating characteristic curve was constructed. Results: A total of 200 subjects were evaluated, 64.5% female, with a mean age of 35.20 ± 13.84 years. Of these, 158 (79%) did not present with carbohydrate metabolism disorder, while 42 (21%) did. Age (p = 0.0001), body mass index (p = 0.011), and waist circumference (p = 0.031) were significantly higher in subjects with impaired glucose regulation when compared to those without it. There were a significantly greater number of sedentary (p = 0.039) and hypertensive subjects (p = 0.0001), as well as those with a history of glucose >100 mg/dL (p = 0.0001), in the impaired glucose metabolism group. A cutoff LA-FINDRISC of 14 points predicted a high risk of impaired glucose regulation with a sensitivity of 45.2% and a specificity of 89.9%. Conclusion: A LA-FINDRISC >14 points had low sensitivity but high specificity for predicting carbohydrate metabolism disorders in this group of patients from Ciudad Bolívar.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…However, this questionnaire was designed for the population of Finland. Thus, it needs to be validated in other populations [7]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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FINDRISC Modified for Latin America as a Screening Tool for Persons with Impaired Glucose Metabolism in Ciudad Bolívar, Venezuela

et al. 2019

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Cardiometabolic risk: New chronic care models

Nieto-Martínez

González-Rivas

Mechanick

2021

J Parenter Enteral Nutr

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Cardiometabolic risk factors, and the chronic cardiovascular diseases (CVDs) that result from them, are highly prevalent in the US and amenable to clinical nutrition interventions. This creates an urgency to develop comprehensive care models that incorporate prevention-based actions by improving lifestyle routines. Such care models should account for social determinants of health, ethnocultural variables, and challenges to sustainability. The relevance of these newly designed chronic care models is to inform and facilitate early intervention, primarily consisting of lifestyle changes and healthy nutrition, which mitigates progression from one stage to subsequent, higher morbidity stages to a greater extent than late intervention. In this article, the mechanistic drivers and ethnocultural validation of the Cardiometabolic-Based Chronic Disease (CMBCD) model are reviewed. Main findings are that in CMBCD, primary (genetics, environment, and behavior) and metabolic (obesity as Adiposity-Based Chronic Disease [ABCD], type 2 diabetes as Dysglycemia-Based Chronic Disease [DBCD], hypertension, and dyslipidemia) drivers initiate and perpetuate the progression of CVD. Epidemiological findings and molecular mechanisms support intra-ABCD/DBCD, as well as ABCD to DBCD stage progression culminating in CVD. The ABCD definition overcomes weight stigma and body mass index underperformance by considering adiposity amount, distribution, and function; and the DBCD definition overcomes criticisms of prediabetes and an exclusive glucocentric approach by considering insulin resistance and residual vascular risk along a clinical spectrum. In conclusion, clinicians should approach patients using the CMBCD model to incorporate lifestyle changes as early as possible to optimally mitigate the burden of CVD.

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