Screening for diabetes and impaired glucose metabolism in Qatar: models’ development and validation

Abstract

Aim: To establish a simple risk score for identifying individuals at high risk of developing Type 2 Diabetes Mellitus (T2DM) in Qatar, based on easy-to-obtain variables. Materials and Methods: A cross sectional sample of 2000 individuals from Qatar BioBank, obtained for the development cohort, was evaluated using the Least Absolute Shrinkage and Selection Operator (LASSO) for feature selection along with logistic regression to determine the predictive variables for the risk of T2DM along with impaired glucose metabolism (IGM). Complex machine learning analyses were performed for comparative purposes. Another sample of 1000 participants was subsequently obtained for external validation of the developed models. Several existing scoring models screening for T2DM were evaluated and compared to the model proposed by this study. Results: 1660 participants were included in the analysis which showed that age, gender, waist-to-hip-ratio, history of hypertension (HTN), history of hypercholesteremia (HCL) and levels of educational were statistically associated with the risk of T2DM and constituted the Qatari diabetes risk score (QDRISK). In addition to the 6 aforementioned variables constituting the QDRISK, the IGM model showed that BMI was statistically significant. The QDRISK performed well with an area under the curve (AUC) 0.870 (95%CI 0.843, 0.896) in the development and 0.815 (95% CI: 0.765, 0.864) and external validation cohort. Compared to the majority of evaluated scores, the QDRISK showed overall better accuracy and calibration. The IGM model performed moderately high with AUC 0.796 (95% CI: 0.774, 0.819) in the development cohort and 0.774 (95% CI: 0.740, 0.809) in the external validation cohort. Conclusions: Our study investigated risk factors for developing T2DM as well as IGM and developed Qatari-specific risk scores based on demographic and anthropometric factors to identify high risk individuals. This simple, cost-effective and convenient tool can guide the development of a nationwide primary prevention program in Qatar.