Performance of diabetes risk scores with or without point of care blood glucose estimation

Abstract

Context: Early detection and optimal treatment of type 2 diabetes mellitus (T2DM) are shown to prevent or delay the complications of the disease. In resource poor settings we need sensitive, specific and inexpensive screening tool to detect people with T2DM. Tools involving point of care blood glucose testing have shown the superiority over others where only history and anthropometry were used. Aims: This study aims to compare the specificity and sensitivity of Indian diabetes risk score (IDRS) and Tabaei and Herman equation based risk score model in a rural community of Northern Karnataka. Materials and Methods: Diabetes prevalence study conducted in rural North Karnataka is used for the present study. All the variables required for calculating IDRS and Tabaei and Herman equation are available from the prevalence study. Instead of random capillary blood glucose, 2 h post 75 g plasma glucose value is used in the equation. And self-reported postprandial time is taken as 2 h. Statistical Analysis: The MedCalc-version 11.3.0 is used for the statistical calculations. DeLong method used to compare the area under receiver operating characteristics (ROCs) of the two risk scores. Results: Three hundred and eighteen participants completed the study and were considered for analysis. In this study optimal, cut-off value for IDRS found to be 40 and for Tabaei et al. equation 0.09. Area under ROC for IDRS was 0.755 (95% CI: 0.680-0.819), and for Tabaei et al. equation it was 0.979 (95% CI: 0.943-0.995). Conclusion: Sensitivity and specificity of T2DM screening tool can be improved by including a point of care blood glucose testing.