A Mobile App for Identifying Individuals With Undiagnosed Diabetes and Prediabetes and for Promoting Behavior Change: 2-Year Prospective Study (Preprint)

2018 ◽  
Author(s):  
Angela YM Leung ◽  
Xin Yi Xu ◽  
Pui Hing Chau ◽  
Yee Tak Esther Yu ◽  
Mike KT Cheung ◽  
...  

BACKGROUND To decrease the burden of diabetes in society, early screening of undiagnosed diabetes and prediabetes is needed. Integrating a diabetes risk score into a mobile app would provide a useful platform to enable people to self-assess their risk of diabetes with ease. OBJECTIVE The objectives of this study were to (1) assess the profile of Diabetes Risk Score mobile app users, (2) determine the optimal cutoff value of the Finnish Diabetes Risk Score to identify undiagnosed diabetes and prediabetes in the Chinese population, (3) estimate users’ chance of developing diabetes within 2 years of using the app, and (4) investigate high-risk app users’ lifestyle behavior changes after ascertaining their risk level from the app. METHODS We conducted this 2-phase study among adults via mobile app and online survey from August 2014 to December 2016. Phase 1 adopted a cross-sectional design, with a descriptive analysis of the app users’ profile. We used a Cohen kappa score to show the agreement between the risk level (as shown in the app) and glycated hemoglobin test results. We used sensitivity, specificity, and area under the curve to determine the optimal cutoff value of the diabetes risk score in this population. Phase 2 was a prospective cohort study. We used a logistic regression model to estimate the chance of developing diabetes after using the app. Paired t tests compared high-risk app users’ lifestyle changes. RESULTS A total of 13,289 people used the app in phase 1a. After data cleaning, we considered 4549 of these as valid data. Most users were male, and 1811 (39.81%) had tertiary education or above. Among them, 188 (10.4%) users agreed to attend the health assessment in phase 1b. We recommend the optimal value of the diabetes risk score for identifying persons with undiagnosed diabetes and prediabetes to be 9, with an area under the receiver operating characteristic curve of 0.67 (95% CI 0.60-0.74), sensitivity of 0.70 (95% CI 0.58-0.80), and specificity of 0.57 (95% CI 0.47-0.66). At the 2-year follow-up, people in the high-risk group had a higher chance of developing diabetes (odds ratio 4.59, P=.048) than the low-risk group. The high-risk app users improved their daily intake of vegetables (baseline: mean 0.76, SD 0.43; follow-up: mean 0.93, SD 0.26; t81=–3.77, P<.001) and daily exercise (baseline: mean 0.40, SD 0.49; follow-up: mean 0.54, SD 0.50; t81=–2.08, P=.04). CONCLUSIONS The Diabetes Risk Score app has been shown to be a feasible and reliable tool to identify persons with undiagnosed diabetes and prediabetes and to predict diabetes incidence in 2 years. The app can also encourage high-risk people to modify dietary habits and reduce sedentary lifestyle.

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Abdel-Ellah Al-Shudifat ◽  
Amjad Al-Shdaifat ◽  
Ahmad Ali Al-Abdouh ◽  
Mohammad Ibrahim Aburoman ◽  
Sara Mohammad Otoum ◽  
...  

Background. The Middle East is the home to the most obese population in the world, and type 2 diabetes mellitus is endemic in the region. However, little is known about risk factors for diabetes in the younger age groups. Methods. The Finnish Diabetes Risk Score (FINDRISC) is a simple, validated tool to identify persons at risk of diabetes. We investigated students at Hashemite University in Jordan with FINDRISC and measured fasting plasma glucose in those who were categorized in the high-risk group. Results. Overall, 1821 students (881 [48.4%] female) were included in the study. Risk factors for diabetes were common: 422 (23.2%) were overweight or obese and 497 (27.3%) had central obesity. Using the FINDRISC score, 94 (5.2%) students were at moderate risk and 32 (1.8%) at high risk of diabetes. The mean FINDRISC score was significantly higher in men than women (5.9 versus 5.4; p=0.002). Twenty-eight students in the high-risk group had a subsequent plasma glucose measurement, and 8 (29%) of them fulfilled the diagnostic criteria for diabetes. Conclusions. Risk factors for diabetes were common in a young student population in Jordan, suggesting that preventive measures should be initiated early in adulthood to turn the diabetes epidemic in the region.


Author(s):  
Divya S. ◽  
Radhamani M. V. ◽  
Kiran Ravi ◽  
Deepa S.

Background: India is the diabetes capital of the world. The burden of diabetes mellitus is increasing daily. If people with higher risk for diabetes are identified before the disease has developed, then some interventions could be undertaken to reduce the modifiable risk factors. Objective of the study was to identify the high risk subjects by using Indian diabetes risk score (IDRS) for detecting undiagnosed diabetes among people aged above twenty five years in rural area of Thrissur.Methods: A cross-sectional study was conducted among 262 inhabitants above 25 in Thrissur. Fasting blood sugar within 3 months prior was noted. The risk of diabetes was assessed using Indian Diabetes Risk Score and grouped into low, moderate and high risk.Results: Majority were females (58.4%) and (80.5%) reported either of their parents as diabetic. Waist circumference was higher for majority. Most (62.2%) people had regular exercise. 199 (76%) had moderate risk. 92% were at moderate to high risk of developing diabetes. Higher the risk score higher was the FBS, and was statistically significant (p=0.035). IDRS was statistically significant with the educational status (p=0.023) and sex (0.000). Forty four (16.8%) were diabetic, 60 (22.9%) hypertensive and 12 (4.6%) had coronary artery disease.Conclusions: There is a shift in age of onset to younger age groups. Hence, the early identification of at risk individuals and appropriate intervention help to prevent, or delay, the onset of complications. This definitely suggests the importance of IDRS for identifying undiagnosed high risk diabetes.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Susanne F. Awad ◽  
Soha R. Dargham ◽  
Amine A. Toumi ◽  
Elsy M. Dumit ◽  
Katie G. El-Nahas ◽  
...  

AbstractWe developed a diabetes risk score using a novel analytical approach and tested its diagnostic performance to detect individuals at high risk of diabetes, by applying it to the Qatari population. A representative random sample of 5,000 Qataris selected at different time points was simulated using a diabetes mathematical model. Logistic regression was used to derive the score using age, sex, obesity, smoking, and physical inactivity as predictive variables. Performance diagnostics, validity, and potential yields of a diabetes testing program were evaluated. In 2020, the area under the curve (AUC) was 0.79 and sensitivity and specificity were 79.0% and 66.8%, respectively. Positive and negative predictive values (PPV and NPV) were 36.1% and 93.0%, with 42.0% of Qataris being at high diabetes risk. In 2030, projected AUC was 0.78 and sensitivity and specificity were 77.5% and 65.8%. PPV and NPV were 36.8% and 92.0%, with 43.0% of Qataris being at high diabetes risk. In 2050, AUC was 0.76 and sensitivity and specificity were 74.4% and 64.5%. PPV and NPV were 40.4% and 88.7%, with 45.0% of Qataris being at high diabetes risk. This model-based score demonstrated comparable performance to a data-derived score. The derived self-complete risk score provides an effective tool for initial diabetes screening, and for targeted lifestyle counselling and prevention programs.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bernard Omech ◽  
Julius Chacha Mwita ◽  
Jose-Gaby Tshikuka ◽  
Billy Tsima ◽  
Oathokwa Nkomazna ◽  
...  

This was a cross-sectional study designed to assess the validity of the Finnish Diabetes Risk Score for detecting undiagnosed type 2 diabetes among general medical outpatients in Botswana. Participants aged ≥20 years without previously diagnosed diabetes were screened by (1) an 8-item Finnish diabetes risk assessment questionnaire and (2) Haemoglobin A1c test. Data from 291 participants were analyzed (74.2% were females). The mean age of the participants was 50.1 (SD = ±11) years, and the prevalence of undiagnosed diabetes was 42 (14.4%) with no significant differences between the gender (20% versus 12.5%,P=0.26). The area under curve for detecting undiagnosed diabetes was 0.63 (95% CI 0.55–0.72) for the total population, 0.65 (95% CI: 0.56–0.75) for women, and 0.67 (95% CI: 0.52–0.83) for men. The optimal cut-off point for detecting undiagnosed diabetes was 17 (sensitivity = 48% and specificity = 73%) for the total population, 17 (sensitivity = 56% and specificity = 66%) for females, and 13 (sensitivity = 53% and specificity = 77%) for males. The positive predictive value and negative predictive value were 20% and 89.5%, respectively. The findings indicate that the Finnish questionnaire was only modestly effective in predicting undiagnosed diabetes among outpatients in Botswana.


Author(s):  
Nazia N. Shaik ◽  
Swapna M. Jaswanth ◽  
Shashikala Manjunatha

Background: Diabetes is one of the largest global health emergencies of the 21st century. As per International Federation of Diabetes some 425 million people worldwide are estimated to have diabetes. The prevalence is higher in urban versus rural (10.2% vs 6.9%). India had 72.9 million people living with diabetes of which, 57.9% remained undiagnosed as per the 2017 data. The objectives of the present study were to identify subjects who at risk of developing Diabetes by using Indian diabetes risk score (IDRS) in the Urban field practice area of Rajarajeswari Medical College and Hospital (RRMCH).Methods: A cross sectional study was conducted using a Standard questionnaire of IDRS on 150 individuals aged ≥20 years residing in the Urban field practice area of RRMCH. The subjects with score <30, 30-50, >or =60 were categorized as having low risk, moderate risk and high risk for developing diabetes type-2 respectively.Results: Out of total 150 participants, 36 (24%) were in high-risk category (IDRS≥60), the majority of participants 61 (41%) were in the moderate-risk category (IDRS 30–50) and 53 (35%) participants were found to be at low-risk (<30) for diabetes. Statistical significant asssociation was found between IDRS and gender, literacy status, body mass index (p<0.0000l).Conclusions: It is essential to implement IDRS which is a simple tool for identifying subjects who are at risk for developing diabetes so that proper intervention can be carried out at the earliest to reduce the burden of diabetes.


2019 ◽  
Vol 10 (1) ◽  
pp. 40-47
Author(s):  
Nazma Akter

Background: Diabetes mellitus (DM) is considered as one of the major health problems worldwide. The rising prevalence of type 2 diabetes mellitus (T2DM) in Bangladesh is primarily attributed to rapid urbanization and associated changes in lifestyle, such as sedentary lifestyle, higher calorie food intake and stressful life. Studies support the utilization of riskassessment scoring systems in quantifying individual’s risk for developing T2DM. Thus, a simple risk-assessment scoring system for early screening of T2DM among Bangladeshi adults will be beneficial to identify the high-risk adults and thus taking adequate preventive measures in combating DM.The purpose of the study was to calculate the risk assessment score of developing T2DM within 10 years among Bangladeshi adults. Methods: The cross-sectional observational study was carried out in the outpatient department (OPD) of Medicine, MARKS Medical College & Hospital, a tertiary care hospital in Dhaka, Bangladesh from February 2018 to July 2018 among randomly sampled 205 adult subjects. Subjects undiagnosed with diabetes mellitus and had previous history of high blood glucose during pregnancy or other health examination (i.e. impaired fasting glucose, impaired glucose tolerance or gestational diabetes mellitus) were included. From a review of literature regarding risk factors of developing DM in Bangladesh, the Finnish Diabetes Risk Score (FINDRISC) system was found to be more useful for the Bangladeshi adults. The Finnish Diabetes Risk Score (FINDRISC) questionnaire was used to collect the data including demographic characteristics and different risk factors and to calculate total risk score for predicting the risk of developing T2DM within 10 years. Results: Among 205 subjects, male and female were 57.1% and 42.9% respectively. The Mean (±SD) age of the study subjects was 37.64±1.07 years. In this study, both non-modifiable and modifiable risk factors showed statistically significant association with the FINDRISC among Bangladeshi adults (p<0.05). There was a significant association among FINDRISC with history of previous high blood glucose, and treated hypertensive Bangladeshi adults.33.65% of the Bangladeshi adults had slightly elevated diabetes risk score (DRS). This study predicts that 17.55% of the Bangladeshi adults may have moderate to high risk to develop T2DM within the consecutive 10 years. Conclusion: This study provides a simple, feasible, non-invasive and convenient screening FINDRISC tool that identifies individuals at risk of having T2DM. People with high risk of DM should be referred for early intervention and changes to a healthy lifestyle and primary prevention to prevent or delay the onset of T2DM. Birdem Med J 2020; 10(1): 40-47


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tao Mao ◽  
Jiayan Chen ◽  
Haijian Guo ◽  
Chen Qu ◽  
Chu He ◽  
...  

The New Chinese Diabetes Risk Score (NCDRS) is one of the recommended tools for screening undiagnosed type 2 diabetes in China. However, its performance in detecting undiagnosed diabetes needs to be verified in different community populations. Also, it is unknown whether NCDRS can be used in detecting prediabetes. In the present study, we aimed to evaluate the performance of NCDRS in detecting undiagnosed diabetes and prediabetes among the community residents in eastern China. We applied NCDRS in 7675 community residents aged 18-65 years old in Jiangsu Province. The results showed that the participants with undiagnosed diabetes reported the highest NCDRS value, followed by those with prediabetes (P<0.001). The best cut-off points of NCDRS for detecting undiagnosed diabetes and prediabetes were 27 (with a sensitivity of 78.0% and a specificity of 57.7%) and 27 (with a sensitivity of 66.0% and a specificity of 62.9%). The AUCs of NCDRS for identifying undiagnosed diabetes and prediabetes were 0.749 (95% CI: 0.739~0.759) and 0.694 (95% CI: 0.683~0.705). These results demonstrate the excellent performance of NCDRS in screening undiagnosed diabetes in the community population in eastern China and further provide evidence for using NCDRS in detecting prediabetes.


2016 ◽  
Vol 16 (1) ◽  
Author(s):  
P. Katulanda ◽  
N. R. Hill ◽  
I. Stratton ◽  
R. Sheriff ◽  
S. D. N. De Silva ◽  
...  

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e97865 ◽  
Author(s):  
Lu Zhang ◽  
Zhenzhen Zhang ◽  
Yurong Zhang ◽  
Gang Hu ◽  
Liwei Chen

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