Abstract
AimsTo assess the diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM and to compare its performance with the Latin-American FINDRISC (LA-FINDRISC) and the Peruvian Risk Score. Materials and methodsA population-based study was conducted. T2DM and undiagnosed T2DM were defined using oral glucose tolerance test (OGTT). Risk scores assessed were FINDRISC, LA-FINDRISC and Peruvian Risk Score. Diagnostic accuracy of risk scores was estimated using the c-statistic and the area under the ROC curve (aROC). A simplified version of FINDRISC was also derived. ResultsData from 1609 individuals, mean age 48.2 (SD: 10.6), 810 (50.3%) women, were collected. A total of 176 (11.0%; 95%CI: 9.4%–12.5%) were classified as having T2DM, and 71 (4.7%; 95%CI: 3.7%–5.8%) were classified as having undiagnosed T2DM. Diagnostic accuracy of the FINDRISC (aROC=0.69), LA-FINDRISC (aROC=0.68), and Peruvian Risk Score (aROC=0.64) was similar (p=0.15). The simplified FINDRISC, with 4 variables, had a slightly better performance (aROC=0.71) than the other scores. ConclusionThe performance of FINDRISC, LA-FINDRISC and Peruvian Risk Score for undiagnosed T2DM was similar. A simplified FINDRISC can perform as well or better for undiagnosed T2DM. The FINDRISC may be useful to detect cases of undiagnosed T2DM in resource-constrained settings.
Highlights
There is an increase in the burden of type 2 diabetes mellitus (T2DM): the age-standardized prevalence of T2DM has increased from 4.3% to 9.0% among men and from 5.0% to 7.9% among women in the last four decades [1]
The American Diabetes Association recommends T2DM testing for all adults starting at age 45 years regardless of weight, or those who are overweight or obese and have one or more additional risk factor for T2DM [7]; the Disease Control Priorities group recommends testing individuals at high-risk of T2DM [6]
Our findings demonstrated that the diagnostic accuracy of the FINDRISC, LA-FINDRISC and Peruvian Risk Score for undiagnosed T2DM was similar
Summary
There is an increase in the burden of type 2 diabetes mellitus (T2DM): the age-standardized prevalence of T2DM has increased from 4.3% to 9.0% among men and from 5.0% to 7.9% among women in the last four decades [1]. In the first step, a risk score – defined as “an objective assessment of the probability of the presence or future development of an adverse health condition” [8] – can be applied to identify subjects at high risk of having or developing T2DM, and, in the second step, a confirmatory test (fasting glucose, oral glucose tolerance test [OGTT] or glycated hemoglobin [HbA1c]) can be performed, but only among those categorized as high risk in the previous step [9]
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