title: Validity of diabetes self-reports in the Saku diabetes study.
abstract: BACKGROUND
  Diabetes is an important risk factor for cardiovascular disease, certain types of cancer, and death, and self-reports are one of the most convenient methods for ascertaining diabetes status. We evaluated the validity of diabetes self-reports among Japanese who participated in a health checkup.
  
  
  METHODS
  Self-reported diabetes was cross-sectionally compared with confirmed diabetes among 2535 participants aged 28 to 85 years in the Saku cohort study. Confirmed diabetes was defined as the presence of at least 1 of the following: fasting plasma glucose (FPG) level of 126 mg/dL or higher, 2-hour post-load glucose (2-hPG) level of 200 mg/dL or higher after a 75-gram oral glucose tolerance test, glycated hemoglobin (HbA1c) level of 6.5% or higher, or treatment with hypoglycemic medication(s).
  
  
  RESULTS
  Of the 251 participants with self-reported diabetes, 121 were taking hypoglycemic medication(s) and an additional 69 were classified as having diabetes. Of the 2284 participants who did not self-report diabetes, 80 were classified as having diabetes. These data yielded a sensitivity of 70.4%, a specificity of 97.3%, a positive predictive value of 75.7%, and a negative predictive value of 96.5%. The frequency of participants with undiagnosed diabetes was 3.0%. Of these, 64.2% had FPG within the normal range and were diagnosed by 2-hPG and/or HbA1c.
  
  
  CONCLUSIONS
  Our findings provide additional support for the use of self-reported diabetes as a measure of diabetes in epidemiologic studies performed in similar settings in Japan if biomarker-based diagnosis is difficult.
authors.affiliation: Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Goto
authors.forename: Akemi
authors.initials: A
authors.lastname: Morita
authors.forename: Maki
authors.initials: M
authors.lastname: Goto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Motohiko
authors.initials: M
authors.lastname: Miyachi
authors.forename: Naomi
authors.initials: N
authors.lastname: Aiba
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kato
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terauchi
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
authors.forename: Shaw
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D057566:Self Report