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

• Published in: Diabetes care Vol. 36; no. 12; pp. 3944 - 3952
• Main Authors: Zhou, Xianghai, Qiao, Qing, Ji, Linong, Ning, Feng, Yang, Wenying, Weng, Jianping, Shan, Zhongyan, Tian, Haoming, Ji, Qiuhe, Lin, Lixiang, Li, Qiang, Xiao, Jianzhong, Gao, Weiguo, Pang, Zengchang, Sun, Jianping
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.12.2013
• Subjects: Adult; Aged; Algorithms; Asian people; Biological and medical sciences; China - epidemiology; Cross-Sectional Studies; Dextrose; Diabetes; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Diagnosis; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Glucose; Glucose metabolism; Health surveys; Humans; Incidence; Male; Medical diagnosis; Medical sciences; Medical screening; Metabolic diseases; Middle Aged; Original Research; Population Surveillance; Prospective Studies; Public health; Reproducibility of Results; Retrospective Studies; Risk assessment; Risk Assessment - methods; Risk Factors; Surveys; Type 2 diabetes; Young Adult; China; Endocrinopathy; Type 2 diabetes; Human; Survey; Nutrition; Surveillance; Risk factor; Metabolic diseases; Risk; Algorithm; Decision tree; Endocrinology
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc13-0593

To develop a New Chinese Diabetes Risk Score for screening undiagnosed type 2 diabetes in China. Data 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). The 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. The 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.