Abstract
AimsTo perform a validation of DIABSCORE in a sample of Tunisian adults and find out the optimal cut-off point for screening of Type 2 diabetes (T2D) and prediabetes.Methods225 adults 18–75 years and a subgroup of 138 adults (18–54 years), with undiagnosed T2D from the region of Cap-Bon, Tunisia were included in the present study. The DIABSCORE was calculated based on: age, waist/height ratio, family history of T2D and gestational diabetes. Receiver operating characteristics (ROC) curves and areas under curve (AUC) were obtained. The T2D and prediabetes prevalences odds ratios (OR) between patients exposed and not exposed to DIABSCORE≥90 and DIABSCORE≥80, respectively were calculated in both age ranges.ResultsFor screening of T2D the best value was DIABSCORE = 90 with a highest sensitivity (Se), negative predictive value (NPV) and lower negative likelihood ratio in participants aged 18–75 yr (Se = 97%; NPV = 97%) when compared to participants aged 18–54 yr (Se = 95%; NPV = 97%); for prediabetes, the best Se and NPV were for DIABSCORE = 80 in both age groups, but it showed a disbalanced sensitivity-specificity. The ROC curves for T2D showed a similar AUC in both age ranges (AUC = 0.62 and AUC = 0.61 respectively). The ROC curves for prediabetes showed a highest AUC in those aged 18–54 years than the older ones (AUC = 0.62 and AUC = 0.57, respectively). The prevalences OR of T2D for DIABSCORE≥90 was higher than for DIABSCORE≥80 in both age ranges. Nevertheless, the prevalences OR of prediabetes for DIABSCORE≥90 was half of the detected for DIABSCORE≥80 in both age ranges.ConclusionThe DIABSCORE is a simple clinical tool and accurate method in screening for T2D and prediabetes in the adult Tunisian population.
Highlights
Diabetes mellitus (DM) is a major risk factor for cardiovascular disease [1]
For screening of Type 2 Diabetes (T2D) the best value was DIABSCORE = 90 with a highest sensitivity (Se), negative predictive value (NPV) and lower negative likelihood ratio in participants aged 18– 75 yr (Se = 97%; NPV = 97%) when compared to participants aged 18–54 yr (Se = 95%; NPV = 97%); for prediabetes, the best Se and NPV were for DIABSCORE = 80 in both age groups, but it showed a disbalanced sensitivity-specificity
The Receiver operating characteristics (ROC) curves for prediabetes showed a highest areas under curve (AUC) in those aged 18–54 years than the older ones (AUC = 0.62 and AUC = 0.57, respectively)
Summary
Diabetes mellitus (DM) is a major risk factor for cardiovascular disease [1]. Diabetes mellitus is one of the largest global health emergencies of the 21st century [2]. Patients with T2D have a higher risk of death from cardiovascular causes compared with their nondiabetic counterparts. The WHO projected that diabetes will be the seventh leading cause of death in 2030 [4] and the mortality rate of DM associated cardiovascular disease is different among ethnic groups and sexes groups [5]. Rates of T2D are speedily growing worldwide, and a number of risk factors contribute to incident diabetes, most prominently age, family history, and obesity [6, 7]. Evidence exits that early detection of established diabetes improves outcome and reduces the incidence of the disease in people with glucose abnormalities, even since prediabetes status has been established
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