Simple risk score to detect rural Asian Indian (Bangladeshi) adults at high risk for type 2 diabetes

Abstract

Aims/IntroductionTo develop and evaluate a simple, non-invasive, diabetes risk score for detecting individuals at high risk for type 2 diabetes in rural Bangladesh.Materials and MethodsData from 2,293 randomly selected individuals aged ≥20 years from a cross-sectional study in a rural community of Bangladesh (2009 Chandra Rural Study) was used for model development. The validity of the model was assessed in another rural cross-sectional study (2009 Thakurgaon Rural Study). The logistic regression model used included age, sex, body mass index, waist-to-hip ratio and hypertension status to predict individuals who were at high risk for type 2 diabetes.ResultsOn applying the developed model to both cohorts, the area under the receiver operating characteristic curve was 0.70 (95% confidence interval 0.68–0.72) for the Chandra cohort and 0.71 (95% confidence interval 0.68–0.74) for the Thakurgaon cohort. The risk score of >9 was shown to have the optimal cut-point to detect diabetes. This score had a sensitivity of 62.4 and 75.7%, and specificity of 67.4 and 61.6% in the two cohorts, respectively. This risk score was shown to have improved sensitivity and specificity to detect type 2 diabetes cases compared with the Thai, Indian, Omani, UK, Dutch, Portuguese and Pakistani diabetes risk scores.ConclusionsThis simple, non-invasive risk score can be used to detect individuals at high risk for type 2 diabetes in rural Bangladesh. Subjects with a score of 9 or above (out of 15) should undergo an oral glucose tolerance test for definitive diagnosis of diabetes.

Development and Validation of a Risk-Score Model for Type 2 Diabetes: A Cohort Study of a Rural Adult Chinese Population

“…Indeed, the incidence and risk factors of T2DM in a population determine the suitability of a risk score. Some scores developed in a particular population often do not perform well in other populations [ 15 ].…”

Diabetes mellitus among arsenic exposed and non-exposed young adults in Bangladesh

“…28,29 This study also revealed that diabetes was more likely (3.1 times) to develop amongst overweight and obese compared to that of underweight young adults. However, in the current study in regards to Waist-Hip ratio, no significant difference of central obese was found between DM, IGT and normal glycaemic status.…”

“…28 But, a recent study conducted in Bangladesh revealed that males were more (1.5 times) likely to develop diabetes. 29 Further, a hospital-based study in Bangladesh also revealed males (1.39 times) were more likely to develop diabetes compared to that of the females.…”

A Scoping Review of Community-Based Geriatric Health Assessment and Screening Tools used in South Asia

“…All studies included participants from all genders and social classes Rathnayake-2020 which was done in post-menopausal women(16). Majority of studies did not specify the theory/model/framework used to build the tools while 5 studies(17)(18)(19)(20)(21) used regression models to develop the tools. The studies characteristics are summarized in table-1 below.…”

“…The included studies reported on 11 tools related to medical assessment in older adults. Four tools - MDRF-IDRS(24), Simple DRS(17), DRS-urban Indians(20), IDRS(25) were for risk scoring of diabetes by regression models using baseline population data. All tools reported moderate sensitivity (range: 62.2%-76.6%) and specificity (range: 59.9-73.7), excellent PPV of over 95% each but poor NPV of below 20%.…”