Abstract

AimTo evaluate the performance of the Finnish Diabetes Risk Score (FINDRISC) and a simplified FINDRISC score (MADRISC) in screening for undiagnosed type 2 diabetes mellitus (UT2DM) and dysglycaemia.MethodsA population-based, cross-sectional, descriptive study was carried out with participants with UT2DM, ranged between 45–74 years and lived in two districts in the north of metropolitan Madrid (Spain). The FINDRISC and MADRISC scores were evaluated using the area under the receiver operating characteristic curve method (ROC-AUC). Four different gold standards were used for UT2DM and any dysglycaemia, as follows: fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), HbA1c, and OGTT or HbA1c. Dysglycaemia and UT2DM were defined according to American Diabetes Association criteria.ResultsThe study population comprised 1,426 participants (832 females and 594 males) with a mean age of 62 years (SD = 6.1). When HbA1c or OGTT criteria were used, the prevalence of UT2DM was 7.4% (10.4% in men and 5.2% in women; p<0.01) and the FINDRISC ROC-AUC for UT2DM was 0.72 (95% CI, 0.69–0.74). The optimal cut-off point was ≥13 (sensitivity = 63.8%, specificity = 65.1%). The ROC-AUC of MADRISC was 0.76 (95% CI, 0.72–0.81) with ≥13 as the optimal cut-off point (sensitivity = 84.8%, specificity = 54.6%). FINDRISC score ≥12 for detecting any dysglycaemia offered the best cut-off point when HbA1c alone or OGTT and HbA1c were the criteria used.ConclusionsFINDRISC proved to be a useful instrument in screening for dysglycaemia and UT2DM. In the screening of UT2DM, the simplified MADRISC performed as well as FINDRISC.

Highlights

  • Diabetes mellitus (DM) affects around 8.3% of the adult population worldwide, and the total number of cases is predicted to rise from 371 million in 2012 to 552 million in 2030 [1]

  • When HbA1c or oral glucose tolerance test (OGTT) criteria were used, the prevalence of undiagnosed T2DM (UT2DM) was 7.4% (10.4% in men and 5.2% in women; p

  • The receiver operating characteristic (ROC)-area under the ROC curve (AUC) of MADRISC was 0.76 with 13 as the optimal cut-off point

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Summary

Introduction

Diabetes mellitus (DM) affects around 8.3% of the adult population worldwide, and the total number of cases is predicted to rise from 371 million in 2012 to 552 million in 2030 [1]. Over 90% of patients with DM have type 2 diabetes mellitus (T2DM), and over 50% of cases are undiagnosed [1]. Interest in identifying individuals with undiagnosed T2DM (UT2DM) is high, considering that there is strong evidence that the progression of uncomplicated T2DM to complicated T2DM can be slowed or stopped with lifestyle modifications [3] or pharmacological interventions [4]

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