A simple screening tool to identify women with previously undiagnosed prediabetes and diabetes mellitus in the community

Authors

  • Indu Waidyatilaka Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo
  • Pulani Lanerolle Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo
  • Sunethra Atukorala Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo
  • Rajitha Wickremasinghe Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama
  • Noel Somasundaram Endocrine Unit, National Hospital of Colombo
  • Angela de Silva Department of Physiology, Faculty of Medicine, University of Colombo

DOI:

https://doi.org/10.18203/2349-3259.ijct20194654

Keywords:

Screening tool, Prediabetes, Diabetes, Dysglycemia, Asia, Sri Lanka

Abstract

Background: In the current context of rising prevalence of non-communicable diseases (NCD), simple low-cost screening tools are essential for identifying individuals who have glucose dysregulation at its early stages. Therefore, we developed and validated a screening tool for dysglycemia (defined as HbA1c≥5.7%) with the potential to identify undiagnosed prediabetes and as well as diabetes mellitus.

Methods: A sample of 2800 women representative of Colombo Municipal Council area was screened using fasting blood glucose for dysglycemia. All (n=272) newly diagnosed dysglycemics and a further 345 normoglycemics were recruited following confirmation of glycemic status by HbA1c, to enable ROC analysis. A pretested questionnaire and the International physical activity questionnaire (IPAQ) validated for Sri Lanka were used to generate variables for the risk score.

Results: A risk score for dysglycemia with a sensitivity of 87% and specificity of 87% and AUC of 0.941 was developed with two common symptoms of dysglycaemia, history of recent increase in frequency of passing urine and recent reduction in vision, one common food related practice, inability to resist sugary food and one indicator of sedentary behavior, TV viewing time and a single anthropometric measurement, waist circumference.

Conclusions: A tool to identify prediabetes is currently unavailable and this new tool fills this gap. Further, the tool is designed to include women with previously undiagnosed diabetes mellitus. Inclusion of lifestyle parameters having a known association with dysglycemia increased the strength of the tool. Early identification will ensure targeting of interventions at the point of maximum effect.

Author Biographies

Indu Waidyatilaka, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo

Senior lecturer,

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Sri Lanka

Pulani Lanerolle, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo

Professor

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Sri Lanka

Sunethra Atukorala, Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo

Professor Emiretus

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Sri Lanka

Rajitha Wickremasinghe, Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama

Professor

Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

Noel Somasundaram, Endocrine Unit, National Hospital of Colombo

Consultant Endocrinologist, Endocrine Unit, National Hospital, Colombo, Sri Lanka

Angela de Silva, Department of Physiology, Faculty of Medicine, University of Colombo

Senior Lecturer,

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Sri Lanka

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Published

2019-10-19

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Original Research Articles