Diabetes Risk Test Research Articles

Associations between periodontal disease severity and selected cardiometabolic risk factors.

To explore associations between periodontal disease (PD) severity and cardiometabolic risk factors, including body mass index (BMI), age, Type 2 Diabetes Mellitus (T2DM) risk, sex, and hypertension (HTN) in patients at an urban dental school clinic. A cross-sectional study design was used to analyze electronic health record data, including periodontal status, demographic characteristics, cardiometabolic risk factors and the American Diabetes Association Diabetes Risk Test (DRT) Score. Chi-square tests and ordinal logistic regression were conducted using SAS 9.4. Of those with available data (n&#61;6,778), 44% were male, 70.2% were overweight/obese, and the mean age was 50.9 (SD&#61;16.6) years. Associations between PD severity and BMI, sex, age, DRT score, and HTN were statistically significant (all p<0.0001) in bivariate analyses. Using logistic regression, HTN (p&#61;0.0006), sex (p<0.0001), and age (p<0.0001) were significant predictors of severe PD which was most common in those with HTN (35.9%), males (31.7%), those >60 years (36.6%). The odds of having severe PD for those with HTN were 1.2 times that of those without HTN. Males were 1.7 times more likely to have severe PD than females. Those aged 40-49 years, 50-59 years, and >60 years were 2.9, 4.2, and 4.3 times more likely to have severe PD than those who were 18-39 years, respectively. All cardiometabolic risk factors were associated with PD severity in bivariate analyses. In the logistic regression model, being older, male, and having HTN were significant predictors of PD severity. Future research is needed with a more diverse sample.

Behavioral responses resulting from e-health services and the role of user satisfaction: the case of the online diabetes test

PurposeThe advancement of technologies has made it possible for health-care organizations to provide convenient online services that enable people to manage their health conditions. Although many studies have investigated the adoption and benefits of e-health services, there has been little focus on health-oriented behaviors after adoption, particularly in relation to service quality and user satisfaction.Design/methodology/approachThis paper is based on the SOR model and service quality theories to investigate behavioral responses, including word-of-mouth, intention to use and intention to act. The authors use a partial least squares structural equation modeling analysis with 194 participants and the diabetes risk test survey in Finland.FindingsThe results show that people are willing to engage in health self-management behaviors if they intend to use the e-health service and are satisfied with it. User satisfaction can be enhanced by improving the visual appeal of the website presentation, the quality of the presented information, as well as the usability of the website, all as components of e-health services.Originality/valueThe authors contribute by creating a construct “intention to act,” referring to health-oriented behaviors resulting from e-health service use. In addition, this study is among the first to apply the SOR model to investigate how user satisfaction leads to intention to use, intention to act and word-of-mouth.

IMPLEMENTATION OF ADA SCREENING TOOLS TO DETERMINE THE BLOOD SUGAR TEST FLOW IN POSYANDU LANSIA

Abstract Introduction: The high incidence of undiagnosed diabetes may increase the incidence of T2DM. Therefore, prediabetes screening activities are needed to detect prediabetes cases early to prevent them from developing into T2DM. Methods: A descriptive research analysis with a cross-sectional approach was conducted in Posyandu Lansia in the area of Sumbersari Health Centre, Jember. The population of this study was all people who visited the Sumbersari Health Centre aged 40 years and over. The number of samples obtained as many as 246 with the sampling technique is systematic random sampling. The Data processing was done descriptively and using the ROC (Receiver Operating Characteristic) test to see the results of the diagnostic test of the ADA Diabetes Risk Test instrument at the Sumbersari Health Centre with a random blood sugar test comparison. Results: From a total of 246 subjects, 159 had prediabetes. The sensitivity value at cut point 5 of 66% and specificity of 36% with a PPV value of 38% and NPV of 64%. While at the optimal cut-off point of 4, the sensitivity value is 90%, and the specificity value is 22%, with a PPV value of 40% and NPV of 77%. Moreover, the ROC curve has an AUC value that is statistically considered less effective, with a value of 56%. Conclusion: ADA Diabetes Risk Test shows promising results for prediabetes screening in the Sumbersari population with high sensitivity for determining disease. Keywords: ADA Diabetes Risk Test, Diabetes Mellitus Type 2, Prediabetes,

The Validity of the American Diabetes Association’s Diabetes Risk Test in A Sample of Egyptian Population

The Validity of the American Diabetes Association’s Diabetes Risk Test in A Sample of Egyptian Population

Diabetes risk assessments and HbA1c-measurements in community pharmacies.

Due to a lack of clear symptoms, type 2 diabetes (T2D) can remain undetected for many years. The aim of the study was to explore if Norwegian community pharmacies could identify individuals with a high risk of developing T2D by offering a diabetes risk assessment service. This study also investigated if the service recruited individuals that the national guideline recommends for diabetes risk assessment, and the proportion of participants who had visited their GP at least once a year. During the inclusion period (September 2016 to the middle of April 2017), pharmacy customers 45 years or older wishing to participate contacted the pharmacy staff. Included participants completed a diabetes risk test and participants with a high risk were offered an HbA1c measurement. At two months after intervention, all participants were followed up. Of the 245 participants, 27% had a high risk of developing T2D. Of these, 46%, 43% and 9% had HbA1c values corresponding to normal (<39 mmol/mol [5.7%]), prediabetes (39-47 mmol/mol [5.7-6.4%]) or above cut-off for diabetes (≥48 mmol/mol [≥6.5%]), respectively. A total of 86% of the participants were in at least one category that the guideline recommends for a diabetes risk assessment, and 88% had visited their GP at least once a year. Norwegian community pharmacies can identify individuals with a high risk of developing T2D by offering a diabetes risk assessment service. Individuals who sought out the service were within the relevant demographics for testing, and a high proportion visited their GP at least once a year.

Assessing the Risk and Awareness of Type 2 Diabetes Mellitus Among Medical Students in Riyadh, Saudi Arabia.

Background Metabolic diseases, such as diabetes mellitus (DM), are increasingly becoming a global problem. Apart from clinical judgment, it is necessary to have reliable, inexpensive, and non-invasive tools to assess the risk of type 2 diabetes mellitus (T2DM), as the disease can be diagnosed years after its onset, with irreversible complications. Methodology This is an observational cross-sectional study conducted at the College of Medicine, King Saud University, located in the capital city of Saudi Arabia. Data was collected through a questionnaire administered to medical students who voluntarily agreed to participate. The risk of T2DM was assessed using the American Diabetes Association diabetes risk test. The collected data was coded, entered into the Statistical Package for Social Sciences software (SPSS; IBM Inc., Armonk, New York), and subsequently analyzed. Results A total of 417 participants were included in our study, with a mean age of 20 ± 2.03 years and a mean body mass index (BMI) of 24.2 ± 5.3. The mean DM risk score was 1.83 ± 1.32 out of a total of 11. Of all the participants, 98.8% had a low-risk score for T2DM, while only 1.2% were identified as having a higher risk of developing T2DM. Approximately 77% of the participants had checked their weight and calculated their BMI in the last year. Among the participants, 98.1% identified obesity as a risk factor for T2DM, 57.8% reported smoking as a risk factor, 96.4% recognized a family history of DM as a risk factor, 80.8% identified a history of gestational DM as a risk factor, and 53.7% reported hypertension as a risk factor for T2DM. Conclusions Most of the study participants demonstrated a good knowledge level and awareness regarding T2DM, with only 1.2% found to be at an increased risk of developing the disease. Our analysis did not identify any significant association between having a high or low-risk score for T2DM and having a high or low awareness level of the disease.

Risk Assessment of Type 2 Diabetes Mellitus Using the American Diabetes Association (ADA) Diabetes Risk Test in Residents of Bah Bolon Village, Simalungun District

Background: The prevalence of DM Type 2 is expected to increase to 7079 per 100,000 individuals in 2030 and 7862 in 2040.Meanwhile, based on Riskesdas data, Indonesia has a prevalence of DM of 2.1% in 2013. The highest prevalence was in Deli Serdang (2.9%) and followed by Medan (2.7%), Pematang Siantar (2.2%), Asahan (2.1%), Gunungsitoli (2,1%), Simalungun (1.57%) and Mandailing Natal (0.3%). The ADA Diabetes Risk Test is a simple strategy that used for screening prediabetes and diabetes in asymptomatic adults. Simalungun Regency is one of the 10 districts with a high prevalence of DM after Medan, Pematang Siantar and Asahan.Bah Bolon Village is one of the villages located in Dolog Masagal District.Bah bolon village is a remote village and far from the city and health facilities covering 342 heads of families. Aim of study is to know about how much risk factor of DM type 2 in Simalungun Distric using ADA Diabetes Risk Test. Methods: This study is analytical with a cross-sectional retrospective design.Data were analyzed after distribution test, then mean difference and correlation test was using the SPPS program where p &lt;0.05 was considered statistically significant. Result: This study showed that the prevalence ratio of the ADA Diabetes Risk Test was 3.04 which indicates that there is an increased risk of DM 3 times compared to individuals who have a low risk ADA Diabetes Risk Test score. The highest prevalence ratio is a history of hypertension. A history of hypertension increases the risk of developing T2DM sixfold. A history of hypertension has a 95% CI value of 2.19-17.84 which indicates that people with hypertension have a 2.19 to 17.84 times higher risk of developing T2DM. Conclusions: The significant association DM about 3 times in ADA Diabetes Risk Test between high score and low score, significant association between hypertension history with hyperglycemia. Keywords: DM Type 2, Risk Factors, ADA Diabetes Risk Test, Screening DM

Screening for diabetes risk using the diabetes risk test and point-of-care hemoglobin A1C values in adults seen in a dental clinic.

To explore the feasibility of screening for type 2 diabetes (T2DM) and the prevalence of adult patients seen in a dental clinic at risk for T2DM based on American Diabetes Association (ADA) diabetes risk test (DRT) scores and Point of Care (POC) Hemoglobin A1C (A1C) values. A cross-sectional analysis of data from adults 18-89 years old seen in an academic dental clinic between November 2019 and April 2022 without prior history of diabetes. Clinical and demographic data were obtained from electronic health records and odontograms. Frequency distributions, chi-square, and Mann-Whitney U tests were used for data analysis. Of the 13,519 patients whose data were included, 54.7% (n=7,389) were female. Of those with race and ethnicity data, 53.6% (n=2,871) were white, 40.2% (n=2,153) were African American, and 29.5% (n=1,559) were Hispanic/Latino. Mean ±SD age was 47.0+17.0 years; mean±SD BMI was 28.0+6.1 kg/m2. Thirty-five percent (n=4,774) had DRT scores reflecting T2DM risk. Those at risk were more likely to be older, male, and overweight/obese than those not at risk (P<0.001). Of those at risk who consented to a POC A1C (9.8%, n=470), 40.2% (n=189) had values consistent with dysglycemia (A1C>5.7%); 34.9% (n=164) reflecting prediabetes (A1C= 5.7-6.4%) and 5.3% (n=25) diabetes (A1C>6.5%). Diabetes screening in a dental clinic identified that over one-third of adults without T2DM were at risk based on DRT scores. Of those who had POC AICs conducted; 40% had dysglycemia. Diabetes screening in an academic dental clinic can help identify patients at risk for T2DM.

Type 2 Diabetes Prevention Programs-From Proof-of-Concept Trials to National Intervention and Beyond.

The prevention of type 2 diabetes (T2D) in high-risk people with lifestyle interventions has been demonstrated by several randomized controlled trials. The intervention effect has sustained up to 20 years in post-trial monitoring of T2D incidence. In 2000, Finland launched the national T2D prevention plan. For screening for high T2D risk, the non-laboratory Finnish Diabetes Risk Score was developed and widely used, also in other countries. The incidence of drug-treated T2D has decreased steadily since 2010. The US congress authorized public funding for a national diabetes prevention program (NDPP) in 2010. It was built around a 16-visit program that relies on referral from primary care and self-referral of persons with either prediabetes or by a diabetes risk test. The program uses a train-the-trainer program. In 2015 the program started the inclusion of online programs. There has been limited implementation of nationwide T2D prevention programs in other countries. Despite the convincing results from RCTs in China and India, no translation to the national level was introduced there. T2D prevention efforts in low-and middle-income countries are still limited, but results have been promising. Barriers to efficient interventions are greater in these countries than in high-income countries, where many barriers also exist. Health disparities by socioeconomic status exist for T2D and its risk factors and form a challenge for preventive interventions. It seems that a stronger commitment to T2D prevention is needed, such as the successful WHO Framework Convention on Tobacco Control, which legally binds the countries to act.

Estimation of type 2 diabetes risk score using diabetes risk test in Neishabour-Iran.

Preventing diabetes and identifying patients who are at risk for it is very important. This study was conducted to estimate the risk score of type 2 diabetes among adults living in Neishabour city in 2020. This descriptive-analytical study was performed on 1000 people aged 25 years and older living in Neishabour (Iran) using a multi-stage sampling method. The data collection instrument included the American Diabetes Association Diabetes Risk Test (DRT), which is a screening instrument to assess the risk of type 2 diabetes. Data analysis was carried out using SPSS ver. 18, using independent t-test, Chi-squared, Fisher's Exact test, Mann-Whitney, path analysis, and regression of generalized estimating equation model at 95% confidence interval. The mean age of the subjects was 43.87 years (SD = 0.419) and 50.7% (n = 507) were female and the rest were male (n = 493). The risk of developing type 2 diabetes was high in 18.4% (n = 184) of the subjects. And the average risk of diabetes in people was 2.76 (SD = 0.057) out of 10 points. There was no significant relationship between gender and gestational diabetes with the risk of diabetes, but there was a significant relationship between age over 40 years, history of hypertension, family history of diabetes, lack of physical activity, and being overweight with the risk of type 2 diabetes. Approximately, one-fifth of the subjects had a high risk of developing type 2 diabetes. Therefore, the use of a simple and practical instrument such as DRT can be suitable for screening and early detection of Prediabetic state and type 2 diabetes.

IDF21-0589 Initial learnings from an eHealth platform for identifying individuals at high risk of diabetes in Mexico

Background: Type 2 diabetes mellitus (DM2) is a leading cause of morbidity and mortality in Mexico. Since the early onset of DM2 is associated with a worse prognosis, the widespread implementation of evaluation risk tests could facilitate its identification among subjects at high risk, in order to promote strategies that reduce the risk and burden of the disease. Aim: To report the initial findings of the open access eHealth platform implementation, based on a chat-box, for the identification of risk factors for diabetes and subjects at high risk of the disease. Method: To identify risk factors for diabetes, an open access eHealth platform (GYANT®) was promoted among the general population in Mexico, through social networks of non-governmental organizations (Mexican Diabetes Federation). This platform is a chat-bot that uses artificial intelligence to guide the conversation with spontaneous users, who provide the information requested. Afterwards, the platform provides the user with a result on their risk profile for diabetes and suggests practical medical care recommendations in a friendly way. Data obtained from January to October 2020 were analyzed to evaluate the performance of this initiative and identify subjects at high risk. The diabetes risk test (DRT) and the metabolic syndrome cohort office-based prediction model (MSCPM) for incidental diabetes were used to define the presence of diabetes risk. Today, the MSCPM is the only predictive model for diabetes in the Mexican population and was developed in middle-aged adults. Results: Data from 23,662 participants were analyzed. The mean age of the participants was 21 ± 9 years, most of them male (51%), with secondary or higher education (79%). The risk factors in the participants were: family history of diabetes (99.1%), overweight (26.1%), hypertension (20%) and obesity (19.8%). Moderate to high risk of diabetes was found in 12%, according to the diabetes risk test, and in 75.4% for the MSCPM (moderate risk [69.1%], moderate-high risk [5.4%] and high risk [0.9%]). A higher BMI was associated with self-reported hypertension (13%), hypercholesterolemia (12.6%), smoking (12%), and poor exercise performance (14.6%). Discussion: Participants in the eHealth platform reported a high prevalence of high-risk factors for diabetes. Early age and a family history of diabetes may have led to participation, which indicates about health concerns that occur in this young adult population. This is the first report of its kind on health initiatives to identify the risk of diabetes in Mexico. We acknowledge that the use of self-reported data is a limitation of this study, as it may be less reliable due to possible lack of precision in responses, as well as possible intentional and unintentional reporting bias. However, we consider that this type of eHealth tools could help to identify subjects with high-risk profiles, so its massive implementation should be considered in health policies, including binding actions to the strategies of diagnosis and/or prevention programs.

Translation and Validation of American Diabetes Association Diabetes Risk Test: The Malay Version.

BackgroundEarly detection of high-risk people for type 2 diabetes mellitus (T2DM) using a simple, non-invasive and cost-effective assessment tool helps to identify and prevent members of the community from developing this disease. Therefore, this study aims to translate the American Diabetes Association (ADA) diabetes risk test for Malaysians and then evaluate its validity.MethodsThis cross-sectional study was conducted between March 2019 and April 2019. The instrument underwent forward and backward translation according to Behling and Law’s technique. Content validity was performed by two experts and face validity was conducted among 35 convenience samples from Kota Bharu, Kelantan. Both were analysed using content validity index and face validity index, respectively.ResultsAll respondents were Malay, and had attained tertiary education with a mean (standard deviation [SD]) age of 20.63 (2.80) years old and BMI of 30.45 (5.99). Among the respondents, 57.1%, 94.3% and 80% were female, single and having a household income below RM1,500, respectively. The Malay translated instrument achieved high I-content validity index (CVI) [0.5–1.0] and S-CVI/Ave [0.93] as well as high I-face validity index (FVI) [0.86–0.97] and S-FVI/Ave [0.91] for understandability, and high I-FVI [0.77–0.91] and S-FVI/Ave [0.85] for clarity.ConclusionThe Malay version of the ADA diabetes risk test was found to be a valid survey instrument to be used for the Malaysian adult population.

Comparison of Three Diabetes Risk Screening Tools Among Non-Hispanic Asian Indian Americans: ADA DRT, MDRF IDRS and HbA1c

The purpose of this study was to compare the relationship between two non-invasive screening tools, the American Diabetes Association Diabetes Risk Test (ADA DRT) and the Madras Diabetes Research Foundation Indian Diabetes Risk Score (MDRF IDRS), with glycated hemoglobin (HbA1c) to determine which tool best predicted HbA1c in Asian Indian Americans. Among Asian Americans, Asian Indian Americans have the highest prevalence of Type 2 diabetes (12.6%). Furthermore, they have a unique genetic predisposition as well as cultural and religious lifestyle practices that may contribute to increased risk. Type 2 diabetes screening tools do not address the unique risk characteristics of Asian Indian Americans. We used clinical and survey data from our previous longitudinal study with a convenience sample of adult Asian Indian Americans (n = 70) selected from a community setting. Following the consenting procedure, all participants completed the ADA DRT and MDRF IDRS questionnaires to identify their diabetes risk. After the initial screening, individuals with an MDRF IDRS score of 50 or above (n = 70) were tested for HbA1c within a month. For this, trained volunteers collected capillary blood using standardized protocol. Descriptive statistics were calculated along with Spearman correlations, Chi-Square test of independence, and linear regressions at an alpha level set at p = .05. A significant, positive relationship (rs = .30, p = .01) was found between the MDRF IDRS score and HbA1c. A positive but weak relationship was also found between ADA DRT and HbA1c (rs = .23). The MDRF IDRS was a better predictor of diabetes risk in Asian Indian Americans than ADA DRT. The MDRF IDRS is a validated, simple, low-cost tool for the detection of diabetes risk in high-risk Asian Indian Americans. Hence, it is a good tool to use for community screenings and patient education for the prevention and management of the risk of Type 2 diabetes.

Using a Socio-Environmental Approach to Explore the Determinants for Meeting the Recommended Physical Activity among Adults at Risk of Diabetes in Rural Indonesia

Moderate-to-vigorous physical activity (PA) is recommended to mitigate the risk of diabetes. This study explored the PA of adults at risk for diabetes in rural Indonesia and determined the requirements for meeting the recommended PA level. In total, 842 adults were screened using a diabetes risk test in a rural health centre; among them, 342 were at risk of diabetes. The level of PA was assessed using the International Physical Activity Questionnaire, whereas the associated factors underlying the three domains –individual, support, and environment—were determined by the Influences on Physical Activity Instrument. The data analysis included a three-step multiple linear regression (MLR) and logistic regression (LR). Overall, 40.6% of the participants met the recommended PA. According to the MLR analysis, among males, individuals who gave PA a higher priority and had enough time to perform PA were predicted to have a higher activity energy expenditure (MET-minutes per week). According to the LR analysis, men were more likely to meet the recommended PA, and people who gave PA a lower priority and had less access to space for PA were less likely to meet the recommended PA level. Strategies for promoting PA in rural Indonesia include focusing on women, people who prioritize PA less, and those who have less time and space in which to be physically active.

The Validity of the American Diabetes Association's Diabetes Risk Test in a Saudi Arabian Population.

IntroductionThe prevalence of type 2 diabetes (T2D) is growing worldwide. This study aimed to assess the sensitivity and specificity of the American Diabetes Association (ADA) and the United States Centers for Disease Control and Prevention's diabetes risk test in identifying Saudi Arabian patients at risk of developing T2D.MethodsWe conducted a one-month cross-sectional study that included patients older than 18 years who visited primary care facilities for any health concern in Riyadh City, Saudi Arabia. We used the Arabic language version of the ADA Prediabetes Risk Test questionnaire, a validated and reliable tool, to collect data. For this study, we analyzed the data using IBM SPSS Statistics for Windows, version 24.0 (IBM Corp., Armonk, New York). Moreover, we calculated sensitivity and specificity, positive predictive values (PPV), negative predictive value (NPV), the area under the curve (AUC), and Youden’s index.ResultsA total of 180 participants were included in the study (121 women and 59 men; mean age = 45 years). The ADA Prediabetes Risk Test sensitivity was 78.9, specificity was 82, PPV was 32, and NPV was 76. Youden’s index was 60.9 and the AUC was 0.6.ConclusionThe ADA prediabetes risk assessment tool is highly sensitive and specific for determining the disease. It is a reliable and valid tool that has not yet been implemented to a great extent in Saudi Arabia. Therefore, future work should study the tool’s effectiveness in risk assessment in additional local Saudi Arabian communities.

Nutritional markers of undiagnosed type 2 diabetes in adults: Findings of a machine learning analysis with external validation and benchmarking.

ObjectivesUsing a nationally-representative, cross-sectional cohort, we examined nutritional markers of undiagnosed type 2 diabetes in adults via machine learning.MethodsA total of 16429 men and non-pregnant women ≥ 20 years of age were analysed from five consecutive cycles of the National Health and Nutrition Examination Survey. Cohorts from years 2013–2016 (n = 6673) was used for external validation. Undiagnosed type 2 diabetes was determined by a negative response to the question “Have you ever been told by a doctor that you have diabetes?” and a positive glycaemic response to one or more of the three diagnostic tests (HbA1c > 6.4% or FPG >125 mg/dl or 2-hr post-OGTT glucose > 200mg/dl). Following comprehensive literature search, 114 potential nutritional markers were modelled with 13 behavioural and 12 socio-economic variables. We tested three machine learning algorithms on original and resampled training datasets built using three resampling methods. From this, the derived 12 predictive models were validated on internal- and external validation cohorts. Magnitudes of associations were gauged through odds ratios in logistic models and variable importance in others. Models were benchmarked against the ADA diabetes risk test.ResultsThe prevalence of undiagnosed type 2 diabetes was 5.26%. Four best-performing models (AUROC range: 74.9%-75.7%) classified 39 markers of undiagnosed type 2 diabetes; 28 via one or more of the three best-performing non-linear/ensemble models and 11 uniquely by the logistic model. They comprised 14 nutrient-based, 12 anthropometry-based, 9 socio-behavioural, and 4 diet-associated markers. AUROC of all models were on a par with ADA diabetes risk test on both internal and external validation cohorts (p>0.05).ConclusionsModels performed comparably to the chosen benchmark. Novel behavioural markers such as the number of meals not prepared from home were revealed. This approach may be useful in nutritional epidemiology to unravel new associations with type 2 diabetes.

Using a Diabetes Risk Score to Identify Patients Without Diabetes at Risk for New Hyperglycemia in the Hospital

ObjectiveTo assess the value of a validated diabetes risk test, the Cambridge Risk Score (CRS), to identify patients admitted to hospital without diabetes at risk for new hyperglycemia (NH). MethodsThis retrospective cross-sectional study included adults admitted to a hospital over a 4-year period. Patients with no diabetes diagnosis and not on antidiabetics were included. The CRS was calculated for each patient, and those with available glycated hemoglobin (HbA1C) results were investigated in a second analysis. Multivariate regression analyses were performed to assess the association among CRS, HbA1C, and the risk for NH. ResultsA total of 19,830 subjects comprised the sample, of which 38% were found to have developed NH, defined as a blood glucose level ≥140 mg/dL. After accounting for covariates, the CRS was significantly associated with NH (odds ratio [OR], 1.19 [1.16, 1.22]; P < .001). Only 17% of patients had their HbA1C values checked within 6 months of admission. Compared with patients without diabetes, patients with prediabetes based on their HbA1C level (OR, 1.59 [1.37, 1.86]; P < .001) and patients with undiagnosed diabetes (OR, 5.95 [3.50, 10.65]; P < .001) were also significantly more likely to have NH. ConclusionResults of this study show that the CRS and HbA1C levels were significantly associated with the risk of developing NH in inpatient adults without diabetes. Given that an HbA1C level was missing in most medical records of hospitalized patients without diabetes, the CRS could be a useful tool for early identification and management of NH, possibly leading to better outcomes.

Evaluation of the Use of a Diabetes Risk Test to Identify Prediabetes in an Employee Wellness Screening

Background: The American Diabetes Association (ADA) Diabetes Risk Test (DRT) is a screening tool to identify people at risk for developing diabetes. Individuals with a DRT score of 5 or higher may have prediabetes or diabetes and should see a healthcare provider. Objective: To determine how many additional employees are identified as being at risk for developing diabetes during an employee wellness screening by using a more stringent DRT cutoff score of 4 instead of 5. Methods: During an annual employee wellness screening event, a hemoglobin A1C (A1c) was drawn for participants with a DRT score of > 4 or by request regardless of risk score. A1C values were classified as normal (<5.7%), prediabetes (>5.7 and <6.5%) or diabetes (>6.5%). Risk scores and A1C values were analyzed using descriptive statistics. Cost of additional laboratory testing was also reviewed. Results: An A1C was collected for 158 participants. Fourteen of 50 (28%) participants with a DRT of 4 had A1c values in the prediabetes range and no history of diabetes or prediabetes. Using the lower DRT score of 4 resulted in an additional expenditure of $305 with $85.40 resulting in the identification of an otherwise unaware person at risk for developing diabetes. Conclusion: Using a DRT cutoff score of 4 as part of an employee wellness screening program resulted in additional laboratory costs to identify persons at risk for developing diabetes but also allowed for earlier education to slow or stop the progression to diabetes which may reduce healthcare costs over time.

ADA Diabetes Risk Test Adaptation in Indonesian Adult Populations: Can It Replace Random Blood Glucose Screening Test?

AimsThe use of non-invasive and easily available assessment tools such as the ADA diabetes risk test is recommended for diabetes screening among general population. This study aims to assess the validity of the ADA diabetes risk test in screening for screening hyperglycemia in Indonesian population.MethodsThis cross-sectional study conducted at primary health care in Cibeber sub district at Cilegon city, Banten province, Indonesia. Subjects were aged ≥45 years old without a prior diagnosis of diabetes were recruited consecutively. The risk of hyperglycemia was measured using the ADA Diabetes Risk Test. Random capillary blood glucose (RcBG) with a cut-off value >140 mg/dL used as a comparison.ResultsFrom a total of 134 subjects, 23.13% of subjects (n = 31) had hyperglycemia. The ADA Diabetes Risk Test gave an area under the ROC curve (AUC) of 0.71 (95% CI: 0.60-0.81) with an optimal cut-off of value ≥5. The sensitivity of the ADA diabetes risk test in diagnosing hyperglycemia was 68% with a false-negative rate (FNR) of 32.26%. Meanwhile, at a cut-off value ≥4, the sensitivity of the ADA Diabetes Risk Test was 93% with an FNR of 9.7%.ConclusionADA diabetes risk test provides a valuable result as a diabetes screening tool in the Indonesian population, thus promotes intervention strategies for population known to be at risk

1442-P: Validity of the American Diabetes Association Diabetes Risk Test in a Low-Income African-American Population

Objective: The use of self-reported data to assess diabetes risk in the general population is a key component of the National Diabetes Prevention Program. The American Diabetes Association Diabetes Risk Test (ADADRT) is a popular tool used for this purpose, yet there is paucity of data on its validity in real-world clinical settings. We assessed the performance of ADADRT in identifying undiagnosed prediabetes or diabetes at a Federally Qualified Health Center serving predominantly African Americans. Methods: The ADADRT was administered to participants without pre-existing diagnosis of prediabetes or diabetes and standard validation measures were calculated using HbA1c as the gold standard. Findings are reported for participants who self-identified as being Black or African American (n = 151). Results: HbA1c identified 25.8% of the sample as having prediabetes or diabetes. At the recommended cutoff for ADADRT (i.e., score ≥5) the following measures were observed: proportion of high-risk persons 47.7%, sensitivity 74.4%, specificity 61.6%, positive predictive value 40.3%, negative predictive value 87.3%, Youden Index 36, and area under the receiver-operating characteristic curve 0.68. Conclusion: ADADRT reasonably identifies low income African Americans with high diabetes risk. Findings are comparable to the precursor to ADADRT as validated with nationally representative data. Disclosure C.C. Chima: None. N. Anikpezie: None. B.C. Wade: None. L.S. Pongetti: None. T. Powell: None. B. Beech: None.