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PLoS One. 2017 Sep 14;12(9):e0184840. doi: 10.1371/journal.pone.0184840. eCollection 2017.

Validation of the diabetes screening tools proposed by the American Diabetes Association in an aging Chinese population.

Author information

1
Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR.
2
Research Centre of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong, Hong Kong SAR.

Abstract

AIM:

Diabetes is a serious global health problem. A simple and effective screening tool should have substantial public health benefit. We investigated the performance of the latest American Diabetes Association diabetes screening methods in our aging Chinese population.

METHODS:

Subjects without diabetes who returned for the 4th Hong Kong Cardiovascular Risk Factors Prevalence Study in 2010-2012 were evaluated for the probability of having diabetes with reference to the age- and body mass index-based screening criteria (screening criteria) and the diabetes risk test (risk test), and the conclusion drawn was compared to their measured glycaemic status. Diabetes was defined by fasting glucose ≥ 7 mmol/L or 2-hour post oral glucose tolerance test glucose ≥ 11.1 mmol/L.

RESULTS:

1415 subjects, aged 58.1±10.2, were evaluated. 95 (6.7%) had diabetes. The risk test showed good accuracy (area under the receiver operating curve 0.725) in screening for diabetes with an optimal cut-off score of five. Compared to the screening criteria, the risk test had significantly better specificity (0.57 vs. 0.41, p<0.001), positive predictive value (0.12 vs. 0.09, p<0.001) and positive diagnostic likelihood ratio (1.85 vs. 1.37, p<0.001). To diagnose one case of diabetes, fewer subjects (11 vs. 18) needed to be tested for blood glucose if the risk test was adopted.

CONCLUSION:

The risk test appears to be a more effective screening tool in our population. It is simple to use and can be adopted as a public health strategy for identifying people with undiagnosed diabetes for early intervention.

PMID:
28910380
PMCID:
PMC5599025
DOI:
10.1371/journal.pone.0184840
[Indexed for MEDLINE]
Free PMC Article

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