title: Screening for Type 2 Diabetes and Dysglycemia in Saudi Arabia: Development and Validation of Risk Scores.
abstract: OBJECTIVE
  The prevalence of type 2 diabetes in Saudi Arabia is the highest worldwide after excluding small island nations. We developed and validated a noninvasive screening test based on demographic and clinical data for identifying adults with undiagnosed diabetes and dysglycemia in Saudi Arabia.
  
  
  METHODS
  Data from 1,485 nonpregnant Saudi adults ≥20 years of age without a current diagnosis of diabetes were obtained from urban and rural primary healthcare centers in 2009. Clinical and demographic data were obtained through physician-administered interviews. Oral glucose tolerance test data were used to define diabetes (fasting plasma glucose ≥7.0 mmol/L or 2-h post-load glucose ≥11.1 mmol/L) and dysglycemia (fasting plasma glucose ≥5.6 mmol/L or 2-h post-load glucose ≥7.8 mmol/L). Predictive models were developed using data from 1,435 individuals. Multivariable logistic regression and receiver operating characteristic curves were used to develop and evaluate a separate risk score for both diabetes and dysglycemia. Scores were validated on a hold-out sample of 50 individuals.
  
  
  RESULTS
  The risk score for undiagnosed diabetes contained age, history of gestational diabetes, smoking, family history of diabetes, and central obesity with a sensitivity of 76.6% and a specificity of 52.1%. The dysglycemia risk score contained age, gestational diabetes, hypertension, and central obesity with a sensitivity of 71.2% and a specificity of 54.0%. All performed equally well, if not better, in the hold-out sample.
  
  
  CONCLUSIONS
  These risk scores can identify Saudi adults with undiagnosed diabetes or dysglycemia and should be validated in prospective studies.
authors.affiliation: 1 Ministry of Health , Riyadh, Kingdom of Saudi Arabia .
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
authors.affiliation: 2 Emory University , Atlanta, Georgia , USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Chang
authors.affiliation: 1 Ministry of Health , Riyadh, Kingdom of Saudi Arabia .
authors.forename: Mohammad Y
authors.initials: MY
authors.lastname: Saeedi
authors.affiliation: 1 Ministry of Health , Riyadh, Kingdom of Saudi Arabia .
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Al Hamid
authors.affiliation: 1 Ministry of Health , Riyadh, Kingdom of Saudi Arabia .
authors.forename: Omer
authors.initials: O
authors.lastname: Abid
authors.affiliation: 2 Emory University , Atlanta, Georgia , USA.
authors.forename: Mohammed K
authors.initials: MK
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001786:Blood Glucose