A self-assessment score helps identify undiagnosed diabetes

Data from the National Health and Nutrition Examination Survey (NHANES) for the years 1999 to 2004 were used to develop the self-assessment model. Date from NHANES years 2005 to 2006, plus data from a combined cohort of 2 community studies, the Atherosclerosis Risk in Communities (ARIC) Study and the Cardiovascular Health Study (CHS),were employed to validate the model.
Study participants were US adults aged 20 years or older. They were defined as having undiagnosed diabetes if they had a fasting plasma glucose level of 7.0 mmol/L  or greater but no  known diabetes.
Analyses identified 6 factors that were independently associated with undiagnosed diabetes (age, sex, family history of diabetes, history of hypertension, obesity, and physical activity). In the NHANES population, a cut-point of 5 or more points selected 35% of adults for diabetes screening. It had a sensitivity of 79%, a specificity of 67%, a positive predictive value of 10%, and a positive likelihood ratio of 2.39. In the ARIC/CHS cohort, a cut-point of 5 or more points selected 40% of adults for diabetes screening. It had a sensitivity of 72%, a specificity of 62%, a positive predictive value of 10%, and a positive likelihood ratio of 1.89. 
Authors conclude that this easy-to-implement diabetes screening score seems to improve somewhat the existing methods.

Studies are needed to evaluate it in diverse populations in real-world settings.

Ann Intern Med. 2009;151:775-783.