title: Two-step approach for the prediction of future type 2 diabetes risk.
abstract: OBJECTIVE
  To develop a model for the prediction of type 2 diabetes mellitus (T2DM) risk on the basis of a multivariate logistic model and 1-h plasma glucose concentration (1-h PG).
  
  
  METHODS
  The model was developed in a cohort of 1,562 nondiabetic subjects from the San Antonio Heart Study (SAHS) and validated in 2,395 nondiabetic subjects in the Botnia Study. A risk score on the basis of anthropometric parameters, plasma glucose and lipid profile, and blood pressure was computed for each subject. Subjects with a risk score above a certain cut point were considered to represent high-risk individuals, and their 1-h PG concentration during the oral glucose tolerance test was used to further refine their future T2DM risk.
  
  
  RESULTS
  We used the San Antonio Diabetes Prediction Model (SADPM) to generate the initial risk score. A risk-score value of 0.065 was found to be an optimal cut point for initial screening and selection of high-risk individuals. A 1-h PG concentration >140 mg/dL in high-risk individuals (whose risk score was >0.065) was the optimal cut point for identification of subjects at increased risk. The two cut points had 77.8, 77.4, and 44.8% (for the SAHS) and 75.8, 71.6, and 11.9% (for the Botnia Study) sensitivity, specificity, and positive predictive value, respectively, in the SAHS and Botnia Study.
  
  
  CONCLUSIONS
  A two-step model, based on the combination of the SADPM and 1-h PG, is a useful tool for the identification of high-risk Mexican-American and Caucasian individuals.
authors.affiliation: Division of Diabetes, University of Texas Health Science Center, San Antonio, TX, USA. abdulghani@uthscsa.edu
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Abdul-Ghani
authors.forename: Tamam
authors.initials: T
authors.lastname: Abdul-Ghani
authors.forename: Michael P
authors.initials: MP
authors.lastname: Stern
authors.forename: Jasmina
authors.initials: J
authors.lastname: Karavic
authors.forename: Tiinamaija
authors.initials: T
authors.lastname: Tuomi
authors.forename: Insoma
authors.initials: I
authors.lastname: Bo
authors.forename: Ralph A
authors.initials: RA
authors.lastname: Defronzo
authors.forename: Leif
authors.initials: L
authors.lastname: Groop
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose