Development and Validation of a Simple Risk Score for Undiagnosed Type 2 Diabetes in a Resource-Constrained Setting.
Objective. To develop and validate a risk score for detecting cases of undiagnosed diabetes in a resource-constrained country.Methods. Two population-based studies in Peruvian population aged ≥35 years were used in the analysis: the ENINBSC survey (n= 2,472) and the CRONICAS Cohort Study (n= 2,945). Fasting plasma glucose ≥7.0 mmol/L was used to diagnose diabetes in both studies. Coefficients for risk score were derived from the ENINBSC data and then the performance was validated using both baseline and follow-up data of the CRONICAS Cohort Study.Results. The prevalence of undiagnosed diabetes was 2.0% in the ENINBSC survey and 2.9% in the CRONICAS Cohort Study. Predictors of undiagnosed diabetes were age, diabetes in first-degree relatives, and waist circumference. Score values ranged from 0 to 4, with an optimal cutoff ≥2 and had a moderate performance when applied in the CRONICAS baseline data (AUC = 0.68; 95% CI: 0.62-0.73; sensitivity 70%; specificity 59%). When predicting incident cases, the AUC was 0.66 (95% CI: 0.61-0.71), with a sensitivity of 69% and specificity of 59%.Conclusions. A simple nonblood based risk score based on age, diabetes in first-degree relatives, and waist circumference can be used as a simple screening tool for undiagnosed and incident cases of diabetes in Peru.
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Antonio
0000-0002-6834-1376
A
Bernabe-Ortiz
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Liam
0000-0002-9168-6022
L
Smeeth
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Área de Investigación y Desarrollo, Asociación Benéfica PRISMA, Lima, Peru.
Robert H
RH
Gilman
Centro Nacional de Alimentación y Nutrición, Instituto Nacional de Salud, Lima, Peru.
Jose R
JR
Sanchez-Abanto
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
William
0000-0003-1106-8812
W
Checkley
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
J Jaime
0000-0002-4738-5468
JJ
Miranda
Universidad Peruana Cayetano Heredia, Lima, Peru.
Cronicas Cohort
CC
Study Group
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