Identifying individuals at risk of type 2 diabetes using risk assessment tools: an overview
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20223241Keywords:
Diabetes, Health risk assessment, Risk model, Risk score, ValidationAbstract
Diabetes is a chronic disorder that arises mainly due to unhealthy lifestyles in genetically susceptible individuals and has affected over 460 million people worldwide. Hence, alternative ways of identifying individuals at risk for developing diabetes are needed. Risk assessment tools can be useful for identifying and segmenting those at higher risk. The goal of this article is to assess various diabetes risk models that have been established in general populations to predict future diabetes, and to compare the technology behind their development and validation. PubMed, Google Scholar and Scopus were searched from inception to 10th November 2021. Studies that reported the use of risk assessment tools to identify individuals at risk of diabetes were included. Of the 9045 articles identified, 28 were included. This study includes six diabetes risk assessment tools, all of which were developed using logistic regression analysis. The most commonly included variables were age and a family history of diabetes. All six tools were subjected to external validation. The risk scores exhibited an overall strong predictive capacity for the population it was developed. However, the external populations had a lower discriminatory performance, implying that risk scores may need to be verified within the group in which they are meant to be utilised. Further, developing the risk tools using modifiable diabetes risk factors and biochemical tests can be more useful for predicting future diabetes.
References
Wanders AJ, Zock PL, Brouwer IA. Trans Fat Intake and Its Dietary Sources in General Populations Worldwide: A Systematic Review. Nutrients. 2017;9(8):840.
Samer NEJ, Naser SSA. Diabetes Prediction Using Artificial Neural Network – PhilPapers. Int J Adv Sci Tech. 2018;121:54-64.
IDF. Diabetes Atlas, 2020. Available at: https://www.idf.org/elibrary/epidemiologyresearch/diabetes-atlas/159. Accessed on 21 October 2022.
Doddaiah SK, Shwetha G, Gopi A, Murthy MRN, Bilimale AS, Anil D. Medical technology intervention in improving the quality of life among the type 2 diabetes mellitus patients. Int J Community Med Public Health 2021;8:4806-11.
Kumar D, Prakash B, Subhash CBJ, Kadkol PS, Arun V, Thomas JJ. An android smartphone-based randomized intervention improves the quality of life in patients with type 2 diabetes in Mysore, Karnataka, India. Diabetes Metab Syndr. 2020;14(5):1327-32.
Doddaiah SK, Prakash B, Chandra BS, Kadkol PS, Arun V, Mohandas A, et al. Effectiveness of smartphone-based intervention on the perceptions of type 2 Diabetes Mellitus patients in Mysuru, Karnataka, India. Obesity Medicine. 2020;20:100295.
Kumar DS, Prakash B, Chandra BS, Kadkol PS, Arun V, Thomas JJ, et al. Technological innovations to improve health outcome in type 2 diabetes mellitus: A randomized controlled study. Clinical Epidemiology and Global Health. 2021;9:53-6.
American Diabetes Association. Screening for type 2 diabetes. Diabetes Care. 2003;26(1):S21-4.
Fowler MJ. Microvascular and macrovascular complications of diabetes. Clinical diabetes. 2011;29(3):116-22.
10. Wellsource. The Ultimate Guide to Health Risk Assessments, 2021. Available at: https://www.wellsource.com/healthriskassessments/. Accessed on 21 October 2022.
Shekelle P, Tucker J, Maglione M, Morton SC, Roth EA, Chao B, Rubenstein L. Evidence report and evidence-based recommendations: Health risk appraisals and Medicare. Baltimore, MD: US Department of Health and Human Services. 2003.
Goetzel RZ, Staley P, Ogden L, Stange PV, Fox J, Spangler J, et al. A framework for patient-centered health risk assessments: providing health promotion and disease prevention services to Medicare beneficiaries, 2011. Available at: file:///C:/Users/Windows%2010/Downloads/cdc_23365_DS1. Accessed on 21 October 2022.
Novus Health. Why a Health Risk Assessment is Important, 2019. Available at: https://www.novushealth.comhealth-riskassessment-is-important. Accessed on 21 October 2022.
Endocrinology Advisor. Diabetes Screening and Prevention, 2019. Available at: https://www.endocrinologyadvisor.com. Accessed on 21 October 2022.
Sytkowski PA, Kannel WB, D'Agostino RB. Changes in risk factors and the decline in mortality from cardiovascular disease. The Framingham Heart Study. N Engl J Med. 1990;322(23):1635-41.
Noble D, Mathur R, Dent T, Meads C, Greenhalgh T. Risk models and scores for type 2 diabetes: systematic review. BMJ. 2011;343:d7163.
Bhutani J, Bhutani S. Worldwide burden of diabetes. Indian J Endocrinol Metab. 2014;18(6):868-70.
Altman DG, Vergouwe Y, Royston P, Moons KG. Prognosis and prognostic research: validating a prognostic model. BMJ. 2009;338:b605.
Moons KG, Royston P, Vergouwe Y, Grobbee DE, Altman DG. Prognosis and prognostic research: what, why, and how? BMJ. 2009;338:b375.
Stiglic G, Pajnkihar M. Evaluation of Major Online Diabetes Risk Calculators and Computerized Predictive Models. PLoS One. 2015;10(11):e0142827.
Chamnan P, Simmons RK, Sharp SJ, Griffin SJ, Wareham NJ. Cardiovascular risk assessment scores for people with diabetes: a systematic review. Diabetologia. 2009;52(10):2001-14.
Chen L, Magliano DJ, Balkau B, Colagiuri S, Zimmet PZ, Tonkin AM, et al. AUSDRISK: an Australian Type 2 Diabetes Risk Assessment Tool based on demographic, lifestyle and simple anthropometric measures. Med J Aust. 2010;192(4):197-202.
CDC. About the Prediabetes Risk Test, 2021. Available at: https://www.cdc.gov/diabetes/widgets/risktest/about-the-test.html. Accessed on 21 October 2022.
CDC. Recognized Lifestyle Change Program, 2021. Available at: https://www.cdc.gov/diabetes/prevention/lifestylchange.html. Accessed on 21 October 2022.
American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(1):S14-S31.
Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003;26(3):725-31.
Day WD, Federation ID, Atlas ID. Test2Prevent - Know your risk of type 2 diabetes, 2021. Available at: https://www.idf.org/type-2-diabetes-risk-assessment/. Accessed on 21 October 2022.
Gao WG, Dong YH, Pang ZC, Nan HR, Wang SJ, Ren J, et al. A simple Chinese risk score for undiagnosed diabetes. Diabet Med. 2010;27(3):274-81.
Griffin SJ, Little PS, Hales CN, Kinmonth AL, Wareham NJ. Diabetes risk score: towards earlier detection of type 2 diabetes in general practice. Diabetes Metab Res Rev. 2000;16(3):164-71.
Dudeja P, Singh G, Gadekar T, Mukherji S. Performance of Indian Diabetes Risk Score (IDRS) as screening tool for diabetes in an urban slum. Med J Armed Forces India. 2017;73(2):123-8.
Adhikari P, Pathak R, Kotian S. Validation of the MDRF-Indian Diabetes Risk Score (IDRS) in another south Indian population through the Boloor Diabetes Study (BDS). J Assoc Physicians India. 2010;58:434-6.
Woo YC, Lee CH, Fong CHY, Tso AWK, Cheung BMY, Lam KSL. Validation of the diabetes screening tools proposed by the American Diabetes Association in an aging Chinese population. PLoS One. 2017;12(9):e0184840.
Bang H, Edwards AM, Bomback AS, Ballantyne CM, Brillon D, Callahan MA, et al. Development and validation of a patient self-assessment score for diabetes risk. Ann Intern Med. 2009;151(11):775-83.
Thomas C, Hyppönen E, Power C. Type 2 diabetes mellitus in midlife estimated from the Cambridge Risk Score and body mass index. Arch Intern Med. 2006;166(6):682-8.
Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005;53:759-63.
Mohan V, Deepa M, Anjana RM, Lanthorn H, Deepa R. Incidence of diabetes and pre-diabetes in a selected urban south Indian population (CUPS-19). J Assoc Physicians India. 2008;56:152-7.
Fleming K, Weaver N, Peel R, Hure A, McEvoy M, Holliday E, et al. Using the AUSDRISK score to screen for pre-diabetes and diabetes in GP practices: a case-finding approach. Aust N Z J Public Health. 2022;46(2):203-207.
Lotfaliany M, Hadaegh F, Asgari S, Mansournia MA, Azizi F, Oldenburg B, et al. Non-invasive Risk Prediction Models in Identifying Undiagnosed Type 2 Diabetes or Predicting Future Incident Cases in the Iranian Population. Arch Iran Med. 2019;22(3):116-24.
Asgari S, Lotfaliany M, Fahimfar N, Hadaegh F, Azizi F, Khalili D. The external validity and performance of the no-laboratory American Diabetes Association screening tool for identifying undiagnosed type 2 diabetes among the Iranian population. Prim Care Diabetes. 2020;14(6):672-7.
Cameron AJ, Magliano DJ, Zimmet PZ, Welborn TA, Colagiuri S, Tonkin AM, et al. The metabolic syndrome as a tool for predicting future diabetes: the AusDiab study. J Intern Med. 2008;264(2):177-86.
Omech B, Mwita JC, Tshikuka JG, Tsima B, Nkomazna O, Amone-P'Olak K. Validity of the Finnish Diabetes Risk Score for Detecting Undiagnosed Type 2 Diabetes among General Medical Outpatients in Botswana. J Diabetes Res. 2016;2016:4968350.
Shao X, Wang Y, Huang S, Liu H, Zhou S, Zhang R, et al. Development and validation of a prediction model estimating the 10-year risk for type 2 diabetes in China. PLoS One. 2020;15(9):e0237936.
Rahman M, Simmons RK, Harding AH, Wareham NJ, Griffin SJ. A simple risk score identifies individuals at high risk of developing Type 2 diabetes: a prospective cohort study. Fam Pract. 2008;25(3):191-6.
Katulanda P, Hill NR, Stratton I, Sheriff R, De Silva SD, Matthews DR. Development and validation of a Diabetes Risk Score for screening undiagnosed diabetes in Sri Lanka (SLDRISK). BMC Endocr Disord. 2016;16(1):42.
Ramachandran A, Snehalatha C, Vijay V, Wareham NJ, Colagiuri S. Derivation and validation of diabetes risk score for urban Asian Indians. Diabetes Res Clin Pract. 2005;70(1):63-70.
Silvanus V, Dhakal N, Pokhrel A, Baral BK, Panta PP. Community based screening for diabetes and prediabetes using the Indian Diabetes Risk Score among adults in a semi-urban area in Kathmandu, Nepal. Nepal Med College J. 2019;21(1):12-20.
Buijsse B, Simmons RK, Griffin SJ, Schulze MB. Risk assessment tools for identifying individuals at risk of developing type 2 diabetes. Epidemiol Rev. 2011;33(1):46-62.
Herman WH. Predicting risk for diabetes: choosing (or building) the right model. Ann Intern Med. 2009;150(11):812-4.
McNeely MJ, Boyko EJ, Leonetti DL, Kahn SE, Fujimoto WY. Comparison of a clinical model, the oral glucose tolerance test, and fasting glucose for prediction of type 2 diabetes risk in Japanese Americans. Diabetes Care. 2003;26(3):758-63.