Abstract
ObjectiveTo evaluate the performance of Finnish Diabetes Risk Score (FINDRISC) in detecting undiagnosed diabetes and prediabetes among U.S. adults by gender and race.MethodsThis cross-sectional analysis included participants (aged ≥20 years) from the National Health and Nutrition Examination Survey (NHANES) 1999–2010. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve and the optimal cutoff points for identifying undiagnosed diabetes and prediabetes were calculated for FINDRISC by gender and race/ethnicity.ResultsAmong the 20,633 adults (≥20 years), 49.8% were women and 53.0% were non-Hispanic White. The prevalence of undiagnosed diabetes and prediabetes was 4.1% and 35.6%, respectively. FINDRISC was positively associated with the prevalence of diabetes (OR = 1.48 for 1 unit increase, p<0.001) and prediabetes (OR = 1.15 for 1 unit increase, p<0.001). The area under ROC for detecting undiagnosed diabetes was 0.75 for total population, 0.74 for men and 0.78 for women (p = 0.04); 0.76 for White, 0.76 for Black and 0.72 for Hispanics (p = 0.03 for White vs. Hispanics). The area under ROC for detecting prediabetes was 0.67 for total population, 0.66 for men and 0.70 for women (p<0.001); 0.68 for White, 0.67 for Black and 0.65 for Hispanics (p<0.001 for White vs. Hispanics). The optimal cutoff point was 10 (sensitivity = 0.75) for men and 12 (sensitivity = 0.72) for women for detecting undiagnosed diabetes; 9 (sensitivity = 0.61) for men and 10 (sensitivity = 0.69) for women for detecting prediabetes.ConclusionsFINDRISC is a simple and non-invasive screening tool to identify individuals at high risk for diabetes in the U.S. adults.
Highlights
Type 2 diabetes prevalence in the U.S is increasing dramatically, with the age-adjusted prevalence of adults increased from 4.5% in 1995 to 8.2% in 2010 [1]
The aim of this study is to evaluate the performance of FINDRISC in identifying undiagnosed diabetes and prediabetes in U.S population by sex and race/ethnicity
Female percentage, percentage of annual household income below $45,000, percentage of married status, body mass index (BMI), waist circumference, fasting plasma glucose (FPG), HbA1c, and systolic blood pressure increased with greater FINDRISC score
Summary
Type 2 diabetes prevalence in the U.S is increasing dramatically, with the age-adjusted prevalence of adults (aged 18 years or older) increased from 4.5% in 1995 to 8.2% in 2010 [1]. Emerging evidence from both observational studies and randomized controlled trials (RCTs) has clearly shown that people with high risk for type 2 diabetes or people at prediabetes stage will be benefited by early identification followed by the intensive lifestyle intervention and pharmacological treatment [5,6,7,8,9] Identifying those individuals becomes crucial and cost efficient. The traditional diabetes screening methods, including the fasting plasma glucose (FPG), the 2-hour oral glucose tolerance test (OGTT) or HbA1c test, are invasive, inconvenient and expensive [10,11] This is one of the important reasons why there are a large number of diabetic patients remaining undiagnosed. It is important to evaluate the performance of the diabetes risk score in a specific population before applying it in this population [24]
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