A simple screening tool to identify women with previously undiagnosed prediabetes and diabetes mellitus in the community
Keywords:Screening tool, Prediabetes, Diabetes, Dysglycemia, Asia, Sri Lanka
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.
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