The accuracy of polyuria, polydipsia, polyphagia, and Indian Diabetes Risk Score in adults screened for diabetes mellitus type-II

Abstract

Context: The World Health Organization report suggests that over 19% of the world's diabetic population currently resides in India. Unfortunately, >50% of the diabetics in India are unaware about their diabetic status. In the poor income country like India, it is essential to use cost-effective methods for screening for diabetes, and traditionally using three classical symptoms and Indian Diabetes Risk Score (IDRS) tool is helpful but, data regarding their diagnostic accuracy is very less. Objective: (1) To assess the diagnostic accuracy of polyuria, polydipsia, polyphagia, and IDRS for detecting diabetes. Settings and Design: Six hundred and seventy-seven adult individuals >20 years of age were screened for diabetes and assessed polyuria, polydipsia, polyphagia, and IDRS score. All were subjected for postprandial blood glucose level. Subjects and Methods: For diagnostic accuracy sensitivity, specificity, positive and negative predictive values, likelihood ratios (LRs, for positive and negative tests), and accuracy was calculated for each symptom. Similarly, by receiver operative curve (ROC) curve analysis, we carried out sensitivity and specificity of IDRS. Results: There was statistically significant association between these three classical symptoms and diabetes status of individuals. When present, all these three symptoms carried 7.34% sensitivity and 98.42% specificity with positive predictive value 47.06% and NPV 84.70%, LR+4.36, LR−0.94 with accuracy of 85%. The optimum cutoff value of IDRS score was >50, which carried sensitivity 73%, specificity 58.7%, and area under curve for ROC was 68% (P < 0.001). Conclusions: This study has shown highest specificity for these three classical symptoms in diagnosing diabetes, but these symptoms were insensitive to detect all diabetic subjects.