Frequent Thirst Research Articles

Application of KNN Machine Learning and Fuzzy C-Means to Diagnose Diabetes

The disease is a common thing in humans. Diseases that attack humans do not know anyone and do not know age. The disease experienced by a person starts from an ordinary level until it can be declared severe to the point of being at risk of death. In this study, the early diagnosis was carried out related to diabetes, where diabetes is a condition in which the sufferer’s body has low sugar levels above normal. Symptoms experienced by sufferers include frequent thirst, frequent urination, frequent hunger, and weight loss. Based on these problems, a system is needed that can quickly find out the diagnosis experienced by a patient. This research aimed to diagnose diabetes early on based on early symptoms. The methods used are KNN and web-based fuzzy C-means. Creating a web-based system can represent medical personnel experts in a fast-diagnosing approach to diabetes. This system was a computer program embedded with the knowledge of the characteristics of diabetes. The results of testing the KNN and Fuzzy C-means applications and methods get an accuracy of 96% for the KNearest Neighbor method, while for the Fuzzy C-Means method with Confusion Matrix calculations, an accuracy of 96% is obtained, so it can be concluded that the Fuzzy C-means method Means better than the K-Nearest Neighbor method.

A Case Report, Cerebral Salt Wasting Syndrome in An Adult

Background: Cerebral Salt Wasting Syndrome (CSW) is a state of sodium loss from the kidneys due to cerebral disorders that cause hyponatremia and decreased extracellular fluid volume. One study found that the main cause of hyponatremia was inappropriate electrolytic therapy, use of diuretics, and a Syndrome of Inappropriate Antidiuretic Hormone (SIADH) as much as 78%, while CSW was as much as 10%. CSW is a cause of hyponatremia which is very difficult to understand and challenging thus, it is very important to distinguish it from the SIADH. This is due to the different management between CSW and SIADH. Case Description: A 47-year-old female complained of weakness, frequent thirst and urination, gradual loss of consciousness, and trembling hands. Physical examination revealed a pulse rate of 120 x/minute. Laboratory results showed that serum Na was 108 mmol/l, urine Na was 511.5 mmol/24 h, urine production was 10.2 L/24 h, urine specific gravity ? 1,005, the fluid balance was minus 3.15 L/24 h, AST 177 U/L, ALT 330 U/L, HbA1C 7.5 %, Random Blood Glucose 234 mg/dL. MRI examination showed small vessel ischemia in the right and left semi-ovale centrum, periventricular and basal ganglia. Abdominal USG showed cholelithiasis. Conclusion: Based on clinical symptoms and laboratory results especially hyponatremia, urine balanced, and MRI possibly the patient was diagnosed with CSW syndrome. Distinguishing CSW from most causes of hyponatremia is usually not difficult. This patient fulfills the diagnosis of Evans Syndrome, but an antiplatelet antibody test is still required. An accurate distinction between the two disorders is essential because SIADH is treated with fluid restriction, whereas CSW requires sodium and fluid replacement.

Assessment of Pharmacy Students Knowledge Regarding Diabetes Mellitus and its Prevention

<p style="text-align: justify;"><strong>Objectives:</strong> The aim of this study is to assess the knowledge of Pharmacy students about diabetes mellitus and its prevention and to identify the factors that affect the disease. <strong>Methods: </strong>A pre-tested questionnaire assessing the knowledge of diabetes mellitus was administered to the students of MM College of Pharmacy to investigate the general understanding of diabetes mellitus. The questions were planned so as to be answered through a Likert type three grade scale. Data was collected and analysed by different statistical methods. <strong>Results:</strong> Data of 330 students of Pharmacy College (112 females and 228 males) were included in this study. Almost all of them (100%) described diabetes as a high blood sugar, about 72% of the students identified frequent hunger 72%, frequent thirst 70% and 68% identified poor wound healing as the main symptoms of the disease. 52% of students reported that they have a family history of diabetes.76% of students evaluated that high blood pressure, 72% said kidney problem etc, are the complications associated with diabetes. 251 students marked HbA1c as a test to check diabetes mellitus. 211 (64%) students think that cure of diabetes is possible. No significant differences were observed in the health behaviour of participants with or without a family history of DM. <strong>Conclusion:</strong> It was found that students had an adequate knowledge and attitudes about diabetes mellitus. However, there is a need for further enhancement in knowledge and attitudes about diabetes mellitus prevention strategies and complications. <p style="text-align: justify;"><strong>Key words: </strong>Diabetes mellitus, Knowledge, Pharmacy students, Prevention, Treatment.

Case Report: Type 2 Diabetes Mellitus for The Elderly with Less Family Support

Mrs. R, 65 years old came to Puskesmas B with complaints of fatigue during activities accompanied by weakness since 1 week ago. The patient has been diagnosed with Diabetes Mellitus since 2 years ago, but the patient admitted that she sometimes went to the health center once every 2 or 3 months depending on her complaints. According to the patient's acknowledgment, initially complaints of fatigue were felt rarely but gradually became more frequent and appeared during light activities and felt continuously. Complaints are not accompanied by blurred vision or numbness.The patient admitted that if the medicine from the Puskesmas ran out, complaints in the form of frequent thirst, frequent urination, hunger, and fatigue were felt again which indicated that the patient's blood sugar was rising, and the patient admitted that the highest blood sugar reached 600 mg/dL. During Mrs. R's treatment, she not only went to the health center for treatment but also frequently went to midwives and paramedics near the house.Mrs. R took the drugs metformin and glimepiride if she had just gone to a health professional when she had a complaint. Additionally, Mrs. R admitted that because of the complaint of feeling weak, Mrs. R often consumed date juice 3 X 1 spoon every day. Mrs. R is often given explanations by health workers to maintain her diet, but according to her she still cannot regulate her diet properly. Mrs. R still can be active and currently the patient is active as a housewife. Every Saturday, Mrs. R follows the exercise program from the village, namely elderly gymnastics, while on other days Mrs. R does not do sports, and only does home activities. Mrs. R denied smoking history, denied drinking alcohol, and denied taking drugs. Mrs. R currently lives with her husband and one grandson.

Identify Prediabetes Risk Factors, Awareness and Dietary Pattern among People in Dijil Discrete- Iraq-2019

Background: Diabetes is the major chronic metabolic disorder that affects 25 of the population in the world.uncontrolled diabetes leads to damage many systems of the body, especially the blood vessels and nerves.(1) Weight loss, Physical activity, healthy diet can reduce the progression from prediabetes to diabetes. (2)Objectives1. Identify prediabetes risk factors, awareness and dietary Pattern among people over 25 years.Method: A Cross sectional descriptive-analytical study with convenience non probability sampling hadbeen carried out during the period from February-April, 2019 that (200) persons over 25 years who attendedthe clinic in AL-Dijil Discrete were interviewed.Results: The study revealed that 40% of the attendance who were over 45 had risk factors as family history,uncontrolled hypertension (?140/90mmHg), hyperlipidemia ((LDLP &gt;140mg/dl), (triglycerides &gt;200mg/dl)), FBS (100-125mg/dl), HB A1c (5.7-6.5%) that mostly were females from urban areas with low education.More than half the of attendance were obese (BMI &gt;30 kg/m²), with physical inactivity. About awarenessof the disease, less than half of the attendance said that the disease presented as frequent thirst and hunger,less said that the disease presented as frequent urination or blurred of vision and occurred due to have familyhistory, obesity and diet, there was statically significance between awareness &amp; education. Regarding todietary pattern, more than half of attendance had poor intake of white meet, fruits and vegetables, 60% hadgood intake of full cream milk product, too much intake of carbohydrate as white bread &amp; rice with oil/daily.Most of them had tea with sugar/daily and less than half had sweets/daily for both sexes.Conclusion: Less than half of the attendance who were over 45 years had prediabetes risk factors, poor lifestyle and dietary habits that mostly were females from urban areas with low education

Prevention of diabetic ketoacidosis at diagnosis of type 1 diabetes: Are certified athletic trainers an untapped resource?

AimsTo assess the knowledge of certified athletic trainers (ATs) on the presenting signs and symptoms of type 1 diabetes (T1D).MethodsWe conducted a 31‐question survey of secondary school ATs recruited from the National Athletic Training Association that established demographic information, knowledge of presenting signs and symptoms of T1D, and previous personal or professional exposure to individuals with T1D. We report descriptive statistics and univariate analyses evaluating the characteristics associated with T1D knowledge. We then report a multivariable model incorporating age, gender, years of experience and education level with T1D knowledge as the dependent variable.Results128 participants (92f:34m) met inclusion criteria and were included in this study. The majority of participants correctly identified frequent thirst (96.1%, n = 123) and frequent urination (85.9%, n = 110) as common presenting signs and symptoms of T1D, while fewer participants identified weight gain (58.6%, n = 75) or joint pain (39.1%, n = 50) as incorrect presenting signs and symptoms of T1D. Participants with over ten years of experience or previous exposure to individuals with T1D had increased T1D knowledge. Participants with advanced education (Master's degree or Doctorate) had no statistically significant difference in T1D knowledge compared to those with a Bachelor's degree. The only factor that demonstrated a significant association with T1D knowledge on multivariable analysis was the female gender.ConclusionsEducational awareness campaigns of T1D symptoms to reduce the rate of DKA at diagnosis of T1D have never included ATs. This study illustrates the importance of targeting future educational interventions on newly trained ATs.

Thirst and factors associated with frequent thirst in patients with heart failure in Spain

BackgroundThirst is a troublesome symptom in patients with Heart Failure (HF) and one that might be perceived differently in different countries depending on climate, food and cultural habits. The aims of the study were to describe thirst frequency, duration and intensity and to identify factors associated with frequent thirst in outpatients with HF in a Mediterranean country. MethodsData was collected in a cross-sectional study involving 302 patients diagnosed with HF (age 67±12 years, 74% male, LVEF 43%±14) in Spain on thirst frequency and duration, and thirst intensity by patient self-report (VAS, 0-100 mm). Clinical variables were collected from the medical files. Regression analysis was used to identify factors independently associated with frequent thirst. ResultsOf all the patients, 143 (47%) were frequently thirsty, and their median (25th and 75th percentiles) thirst intensity was higher (VAS 50 mm [20-67] vs 7 [0-20], p<.001). Their thirst lasted longer compared to those who never/sometimes were thirsty (p<.001). Less treatment with angiotensin receptor blockers (Odds Ratio [OR] 2.72; 95% Confidence Interval [CI] 1.33–5.58), diuretics >40 mg/day (OR 1.92; 95% CI 1.02-3.64), depression (OR 2.99; CI 1.17–7.62), male gender (OR 1.98; CI 1.08–3.64) and worse New York Heart Association functional class (OR 1.92; 95% CI 1.05-3.52) were independently associated with frequent thirst. ConclusionsAbout half of patients with HF and fluid restriction experienced frequent thirst in a Mediterranean area of Spain, and their thirst duration and intensity were significantly increased. Frequent thirst was associated with demographic, clinical and therapeutic variables. The results may help to identify patients with a higher risk of frequent thirst and might suggest therapeutic changes in order to diminish this troublesome symptom.

Clinical presentation of newly diagnosed diabetes patients in a rural district hospital in Eastern Uganda.

Our objective was to describe the clinical presentation of new diabetes patients in a rural hospital, to enhance clinical detection in low resource settings. A case series assessment of 103 new diabetes patients consecutively enrolled at Iganga Hospital in rural Eastern Uganda was conducted. All underwent a basic clinical assessment through the clinic's routine procedures. Following diagnosis, variables pertinent to the study (symptoms, blood pressure, anthropometry, and blood glucose) were secondarily abstracted from their clinical records. Fiftty two percent of new diabetes patients were female. The mean age was 49 years (SD=14.4). Two clinical symptoms were present in almost all new patients: Frequent urination (100%) and frequent thirst (79%). Moderately occurring symptoms (i.e. 25-50% of patients) included blurred vision, frequent eating and frequent sweating. The mean duration of symptoms was 1.4 years; 48% had high blood pressure while 46% were overweight. Random blood sugar was normal for 25% of patients. The majority (71%) were classified as having 'moderate illness' at diagnosis. Severe illness was significantly lower among patients aged 40 or older compared to younger patients (OR 0.1; 95% CI 0.03-0.35). Out-patients aged 40-65 years should be prioritised for early diabetes diagnosis and associated risk factors in this setting.

Analysis of Dietary Related Factors of Recurrent Aphthous Stomatitis among College Students.

Objective We investigated the occurrence of recurrent aphthous stomatitis (RAS) among college students and its potential influence by dietary habits. Methods Study of dietary habits and RAS among students in Beijing University of Chinese Medicine was carried by homemade questionnaire. Multivariate binary logistic regression analysis was used to identify RAS risk factors and explore their relations. Results Among 1011 investigated college students, family history (odds ratio (OR) 1.678, 95% confidence intervals (CI) 1.192 to 2.364, p < 0.05), bed late (OR 1.515, 95% CI 1.005 to 2.285, p < 0.05), frequent thirst (OR 1.842, 95% CI 1.393 to 2.435, p < 0.001), and frequent drinking carbonated beverages (OR 1.369, 95% CI 1.029 to 1.821, p < 0.05) were independent risk factors for RAS, but preference for nuts (OR 0.607, 95% CI 0.448 to 0.824, p < 0.001) was a protective factor. There was no statistical difference in fruit intake between RAS and non-RAS groups (χ2 = 5.249, p > 0.05). Conclusions Among college students, frequent drinking carbonated beverages or frequent thirst will increase its possibility, whereas preference for nuts provides protection. In addition, fruit intake does not have a positive effect.

Pharmacy students' knowledge and attitudes towards diabetes: a cross-sectional study

Objective: This study aimed to evaluate knowledge and attitudes of pharmacy students about diabetes mellitus. Methods: A cross sectional study using self-administered questionnaire was conducted from 25th February to 15th March 2018 among pharmacy students of King Saud University. A total of 120 students were randomly recruited using a multistage sampling method and were invited to participate in the study. Results: A total of 43.1% (n=50) of the students had a good knowledge about diabetes mellitus. Majority 74.2% (n=86) agreed that personal efforts will help to manage or control diabetes mellitus. Almost all of them (97%) described diabetes as a high blood sugar, about 96% of the students identified frequent urination, followed by frequent hunger 56%, frequent thirst 69% as main symptoms of the disease. Most students (70%) believed that diabetes mellitus is a genetic disorder. Most common complications mentioned by students were eye disease (65%), foot problem (62%), kidney diseases (59%) and cardiovascular diseases (42%). Conclusion: The finding of this study indicate that students had an adequate knowledge and attitudes about diabetes mellitus, however there is a need for further improvement in knowledge and attitudes about diabetes mellitus prevention strategies and complications.

Soft-computing: An Objective Approach in Varied Diabetes Recognition

Diabetes is a chronic disorder caused by elevated glucose within the blood stream. The predominant indicator of diabetes include a glucose level of more 125mg/dl in addition to frequent thirst, unusual thirst, extreme fatigue blurred vision and frequent infection. Existing approach for the recognition of diabetes are to two classes (Type I and Type II) in addition to their subjective approach. This research paper proposed an objective approach utilizing soft-computing techniques for the recognition of five class of diabetes.

Fatal Thirst: Diabetes in Britain until Insulin (review)

Reviewed by: Fatal Thirst: Diabetes in Britain until Insulin Lynda Payne Elizabeth Lane Furdell. Fatal Thirst: Diabetes in Britain until Insulin. History of Science and Medicine Library, vol. 9. Leiden, Netherlands: Brill, 2009. xii + 194 pp. $158.00 (978-9-0041-7250-0). Elizabeth Lane Furdell has written a thorough overview of the history of diabetes before 1922 and the breakthrough of insulin treatment. Her focus is Britain (predominantly England) and the debates that swirled around a condition that caused misery for patients and confusion for healers. The early chapters focus on the long global history of diabetes from the identification of frequent thirst and urination as the cardinal signs of the disease by Hindu authors in the sixteenth century BCE to the English Renaissance. Although this is necessarily rapid, Furdell manages to weave together an interesting narrative of great healers who influenced the treatment of diabetes. Galen was influential in prescribing diet and vigorous horseback riding despite the fact that he saw only two cases of diabetes in his lifetime. Galenists favored bleedings and purgings to balance the humoral makeup of the patient, while Paracelsians promoted new chemical remedies and the old art of uroscopy, or examining flasks of urine. True to her pledge in the introduction to discuss patients as well as healers, Furdell identifies Cardinal Wolsey and Sir Christopher Hatton as probable diabetics and speculates on what treatments a contemporary physician, Dr. Linacre, would have recommended. Similarly she discusses the case histories of Theodore Turquet de Mayerne and shows how sixteenth-century physicians were attempting to add [End Page 518] new treatments to Galenic medicine and prescribing individual treatments for diabetes. Furdell includes an interesting chapter on the ways in which ideas about the disease circulated in print that addresses the immense medico-astrological influence of Nicholas Culpeper. He recommended eating dried animal bladders especially from goats as a beneficial diet, goats being associated with Saturn and Saturn with diabetes. Such vernacular remedies circulated widely among healers and patients in early modern England. In the later seventeenth century Thomas Willis and Thomas Sydenham battled over the cause of diabetes and potential dietary cures. Furdell ably shows how differences both political (their families were on opposing sides in the English Civil War) and philosophical (Willis dissected and experimented while Sydenham practiced trial and error medicine at the bedside) influenced the care of patients. The resistance of many patients to treatment in the eighteenth and nineteenth centuries exasperated doctors, particularly as hospitals became the places where clinical research was carried out on diets. Richard Bright (of Bright's disease) at Guys in London had his patients keep a log of how much they drank and urinated. At least, unlike other physicians, Furdell explains, Bright did not prescribe sugary foods to replace the sugar found in the urine of diabetics. The final chapters of the book discuss diabetic specialists and the flooding of the market with self-help literature before the discovery of insulin in 1922. Sufferers from diabetes were stigmatized as lazy and uncooperative—an image that lingered on even after insulin became available in Britain. Furdell has produced an impressive and compassionate history of an old disease that continues to affect many new lives today. It would be a useful text to assign in an upper-division or graduate-level history of medicine course. Lynda Payne University of Missouri, Kansas City Copyright © 2010 The Johns Hopkins University Press

Perceptions of risk in adults with a low or high risk profile of developing type 2 diabetes; a cross-sectional population-based study

To compare the perceived seriousness and risk of type 2 diabetes among low risk with high risk profile non-diabetic subjects and examine the relationship of perceived risk with multiple self-reported risk indicators. A cross-sectional population-based study among 4435 low risk profile and 2607 high risk profile non-diabetic residents of the Hoorn region, participating in a stepwise type 2 diabetes screening study. Main outcome measures were perceived seriousness and risk of diabetes in subjects categorized (low vs. high risk profile) using the Symptom Risk Questionnaire. 85.0% of the low risk and 81.2% of the high risk profile subjects perceived diabetes as a moderate to very serious disease. About half (43.0%) of all 7042 subjects reported that they do not know their risk of having diabetes. The mean perceived risk of having diabetes was slightly lower for the low risk compared with the high risk profile subjects (difference = 2.8%; 95% confidence interval [CI] = 1.8% to 3.8%; P < 0.001). This difference was mostly explained by having a parent or sibling with diabetes, frequent thirst and claudication (difference = 0.6%; 95% CI = -0.7% to 1.9%). Interestingly, perceived risk decreased with increasing age within both groups (P for trend < 0.001). Both low risk and high risk profile subjects perceive diabetes as a serious disease. Even among those at high risk profile for type 2 diabetes, almost half appeared not to know their risk. Perceived risk of having diabetes was slightly lower for the low risk compared with the high risk profile subjects. Furthermore, perceived risk decreases with increasing age. This study points to a greater need to effectively address people's (mis)perceptions, and how to raise the awareness and understanding of type 2 diabetes and its risk factors in the general population in order to influence early detection and healthy lifestyle changes.

Physical fatty acid deficiency signs in children with ADHD symptoms

Fatty acid deficiency symptoms (FADS) of dry hair and skin, frequent thirst and urination have been observed to be higher in children with attention deficit hyperactivity disorder (ADHD). Two studies investigated FADS in 7–12-year-old children; Study 1 in a general population ( N=347) and Study 2 in children with ADHD symptoms ( N=104). Correlations between FADS and ADHD-related symptoms were found at baseline in Study 1 but not Study 2. FADS did not improve after supplementation with omega-3 and omega-6 polyunsaturated fatty acids (PUFA) versus placebo after 15 weeks in Study 2, and were not related to improvements in ADHD symptoms in the PUFA groups. However, FADS did improve in all groups, possibly attributable to the linoleic acid present in both the PUFA and placebo (palm oil) supplements. FADS are not a reliable selection criterion for children with ADHD who might benefit from omega-3 PUFA supplementation.

A Study on the Nutritional Status of Diabetics and Associated Risk Factors

Nutritional status of 115 subjects (56 male and 59 females) suffering with NIDDM and attending a diabetic clinic was determined using standard techniques. A questionnaire was designed to collect information regarding background of patients, family history and clinical history. Anthropometry included measurement of height, weight, mid upper arm circumference and tricep skin fold. Diet history was collected using 24 hr recall and food frequency. Data revealed that a majority of subjects were between 50-65 years of age, Hindu by religion, studied up to undergraduate level and were from lower and middle income group.The onset of disease was noticed between 40-45 years with higher incidences up to 60 years. The symptom of frequent thirst and urination was more common. Many reported family history of diabetes from parent’s side. Fasting blood sugar level of >120 mg/ dl was reported by majority of subjects. The incidence of anemia was more in women. Among associated risk factors, eye and heart problems were predominant. Anthropometry of patients revealed that 60 (M) and 49% (F) of patients were in normal range of BMI, 33.9 (M) and 35.6 % (F) were over weight and 5.4 (M)) and 13% (F) were obese. 49 and 34 % of female subjects and 41 and 17 % of male subjects had higher than ideal tricep skin fold and waist-hip ratio respectively. Diet survey showed the intake of carotene, iron, vitamin C, niacin and riboflavin to be inadequate and that of calcium, fat and thiamine to be adequ

Acquired generalized anhidrosis associated with lymphocytic infundibuloneurohypophysitis

Acquired idiopathic generalized anhidrosis (AIGA) has an acute or insidious onset without additional symptoms. There may be eccrine gland dysfunction, and the beneficial effects of corticosteroids lend support to an autoimmune etiology.1,2⇓ Lymphocytic infundibuloneurohypophysitis (LIN) is an inflammatory disorder that can result in central diabetes insipidus (DI); histologic findings showing infiltration of lymphocytes suggest an autoimmune etiology.3 We describe a case of AIGA associated with LIN. A 25-year-old man was in good health until December 1999, when he noticed a cutaneous eruption with itching in the trunk and arms after physical exercise or exposure to a hot environment, accompanied by generalized anhidrosis. He also experienced frequent thirst and increased fluid consumption. There was no history of syncope, impotence, or urinary symptoms. On his first admission in July 2001, general physical examination revealed normal findings except for dry skin. On neurologic examination, pupils were equal and reacted to light well. Muscle strength, tone, and muscle …

Traitement du diabète insipide en 1999

Most cases of acquired central diabetes insipidus are caused by destruction of the neurohypophysis by: 1) anatomic lesions that destroy the vasopressin neurons by pressure or infiltration, 2) damage to the vasopressin neurons by surgery or head trauma, and 3) autoimmune destruction of the vasopressin neurons. Because the vasopressin neurons are located in the hypothalamus, lesions confined to the sella turcica generally do not cause diabetes insipidus because the posterior pituitary is simply the site of the axon terminals that secrete vasopressin into the bloodstream. In addition, the capacity of the neurohypophysis to synthesize vasopressin is greatly in excess of the body's needs, and destruction of 80–90% of the hypothalamic vasopressin neurons is required to produce diabetes insipidus. As a result, even large lesions in the sellar and suprasellar area generally are not associated with impaired water homeostasis until they are surgically resected. Regardless of the etiology of central diabetes insipidus, deficient or absent vasopressin secretion causes impaired urine concentration with resultant polyuria. In most cases, secondary polydipsia is able to maintain water homeostasis at the expense of frequent thirst and drinking. However, destruction of the osmoreceptors in the anterior hypothalamus that regulate vasopressin neuronal activity causes a loss of thirst as well as vasopressin section, leading to severe chronic dehydration and hyperosmolality. Vasopressin deficiency also leads to down-regulation of the synthesis of aquaporin-2 water channels in the kidney collecting duct principal cells, causing a secondary nephrogenic diabetes insipidus. As a result, several days of vasopressin administration are required to achieve maximal urine concentration in patients with CDI. Consequently, the presentation of patients with central diabetes insipidus can vary greatly, depending on the size and location of the lesion, the magnitude of trauma to the neurohypophysis, the degree of destruction of the vasopressin neurons, and the presence of other hormonal deficits from damage to the anterior pituitary.

Performance of an NIDDM screening questionnaire based on symptoms and risk factors.

To investigate to what extent a short questionnaire on symptoms and risk factors can be used to identify people at increased risk for undiagnosed NIDDM. A general population sample of 2,364 Caucasian subjects, age 50-74 years, not known to have diabetes, completed a questionnaire on diabetes-related symptoms and risk factors. Subsequently, they underwent an oral glucose tolerance test. A backward stepwise multiple logistic regression was carried out with the absence or presence of newly detected diabetes as the dependent variable and the items from the questionnaire as the independent variables. The selected items were included in a new symptom risk questionnaire, which was evaluated in a different population sample of 786 subjects, age 45-74 years, not known to have diabetes and compared with existing questionnaires. The newly developed symptom-risk questionnaire contains questions concerning the following items, which were independently and significantly (P < 0.05) associated with the presence of previously undiagnosed diabetes: pain during walking with need to slow down, shortness of breath when walking with people of the same age, frequent thirst, age, sex, obesity, parent or sibling with diabetes, use of antihypertensive drugs, and reluctance to use a bicycle for transportation. The 1993 American Diabetes Association questionnaire, the 1995 Herman et aL (17) questionnaire, and the newly developed symptom-risk questionnaire had sensitivities of 59, 72, and 72%; specificities of 57, 55, and 56%; positive predictive values of 5.6, 6.4, and 6.5%; and negative predictive values of 97, 98, and 98%, respectively. The newly developed symptom-risk questionnaire has good performance characteristics, and the advantage of a variable cutoff makes it a useful screening tool for NIDDM in general practice.