Validity of the Finnish Diabetes Risk Score for Detecting Undiagnosed Type 2 Diabetes among General Medical Outpatients in Botswana
Identifieur interne : 002616 ( Pmc/Curation ); précédent : 002615; suivant : 002617Validity of the Finnish Diabetes Risk Score for Detecting Undiagnosed Type 2 Diabetes among General Medical Outpatients in Botswana
Auteurs : Bernard Omech [Botswana] ; Julius Chacha Mwita [Botswana] ; Jose-Gaby Tshikuka [Botswana] ; Billy Tsima [Botswana] ; Oathokwa Nkomazna [Botswana] ; Kennedy Amone-P'Olak [Botswana]Source :
- Journal of Diabetes Research [ 2314-6745 ] ; 2016.
Abstract
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%,
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DOI: 10.1155/2016/4968350
PubMed: 27738638
PubMed Central: 5055990
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xml:lang="fr">Botswana</country><wicri:regionArea>Department of Psychology, University of Botswana, Private Bag UB 00713, Gaborone</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27738638</idno><idno type="pmc">5055990</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055990</idno><idno type="RBID">PMC:5055990</idno><idno type="doi">10.1155/2016/4968350</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">002617</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002617</idno><idno type="wicri:Area/Pmc/Curation">002616</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002616</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Validity of the Finnish Diabetes Risk Score for Detecting Undiagnosed Type 2 Diabetes among General Medical Outpatients in Botswana</title><author><name sortKey="Omech, Bernard" sort="Omech, Bernard" uniqKey="Omech B" first="Bernard" last="Omech">Bernard Omech</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Internal Medicine, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Internal Medicine, University of Botswana, Private Bag UB 00713, Gaborone</wicri:regionArea></affiliation></author><author><name sortKey="Mwita, Julius Chacha" sort="Mwita, Julius Chacha" uniqKey="Mwita J" first="Julius Chacha" last="Mwita">Julius Chacha Mwita</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Internal Medicine, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Internal Medicine, University of Botswana, Private Bag UB 00713, Gaborone</wicri:regionArea></affiliation></author><author><name sortKey="Tshikuka, Jose Gaby" sort="Tshikuka, Jose Gaby" uniqKey="Tshikuka J" first="Jose-Gaby" last="Tshikuka">Jose-Gaby Tshikuka</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Public Health, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Public Health, University of Botswana, Private Bag UB 00713, Gaborone</wicri:regionArea></affiliation></author><author><name sortKey="Tsima, Billy" sort="Tsima, Billy" uniqKey="Tsima B" first="Billy" last="Tsima">Billy Tsima</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Family Medicine, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Family Medicine, University of Botswana, Private Bag UB 00713, Gaborone</wicri:regionArea></affiliation></author><author><name sortKey="Nkomazna, Oathokwa" sort="Nkomazna, Oathokwa" uniqKey="Nkomazna O" first="Oathokwa" last="Nkomazna">Oathokwa Nkomazna</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Ophthalmology, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Ophthalmology, University of Botswana, Private Bag UB 00713, Gaborone</wicri:regionArea></affiliation></author><author><name sortKey="Amone P Olak, Kennedy" sort="Amone P Olak, Kennedy" uniqKey="Amone P Olak K" first="Kennedy" last="Amone-P'Olak">Kennedy Amone-P'Olak</name><affiliation wicri:level="1"><nlm:aff id="I5">Department of Psychology, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Psychology, University of Botswana, Private Bag UB 00713, Gaborone</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Diabetes Research</title><idno type="ISSN">2314-6745</idno><idno type="eISSN">2314-6753</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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%, <italic>P</italic> = 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. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Diabetes Res</journal-id><journal-id journal-id-type="iso-abbrev">J Diabetes Res</journal-id><journal-id journal-id-type="publisher-id">JDR</journal-id><journal-title-group><journal-title>Journal of Diabetes Research</journal-title></journal-title-group><issn pub-type="ppub">2314-6745</issn><issn pub-type="epub">2314-6753</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27738638</article-id><article-id pub-id-type="pmc">5055990</article-id><article-id pub-id-type="doi">10.1155/2016/4968350</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Validity of the Finnish Diabetes Risk Score for Detecting Undiagnosed Type 2 Diabetes among General Medical Outpatients in Botswana</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-3087-736X</contrib-id><name><surname>Omech</surname><given-names>Bernard</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-5947-3684</contrib-id><name><surname>Mwita</surname><given-names>Julius Chacha</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tshikuka</surname><given-names>Jose-Gaby</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-8534-7198</contrib-id><name><surname>Tsima</surname><given-names>Billy</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nkomazna</surname><given-names>Oathokwa</given-names></name><xref ref-type="aff" rid="I4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Amone-P'Olak</surname><given-names>Kennedy</given-names></name><xref ref-type="aff" rid="I5"><sup>5</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Internal Medicine, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</aff><aff id="I2"><sup>2</sup>Department of Public Health, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</aff><aff id="I3"><sup>3</sup>Department of Family Medicine, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</aff><aff id="I4"><sup>4</sup>Department of Ophthalmology, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</aff><aff id="I5"><sup>5</sup>Department of Psychology, University of Botswana, Private Bag UB 00713, Gaborone, Botswana</aff><author-notes><corresp id="cor1">*Bernard Omech: <email>bgomech@gmail.com</email></corresp><fn fn-type="other"><p>Academic Editor: Ulrike Rothe</p></fn></author-notes><pub-date pub-type="ppub"><year>2016</year></pub-date><pub-date pub-type="epub"><day>22</day><month>9</month><year>2016</year></pub-date><volume>2016</volume><elocation-id>4968350</elocation-id><history><date date-type="received"><day>4</day><month>5</month><year>2016</year></date><date date-type="accepted"><day>28</day><month>8</month><year>2016</year></date></history><permissions><copyright-statement>Copyright © 2016 Bernard Omech et al.</copyright-statement><copyright-year>2016</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>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%, <italic>P</italic> = 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.</p></abstract><funding-group><award-group><funding-source>University of Botswana</funding-source></award-group></funding-group></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>The distribution of normal glycaemia, dysglycaemia, and undiagnosed T2D within the FINDRISC categories among the participants. The figures are percentage prevalence within the FINDRISC category.</p></caption><graphic xlink:href="JDR2016-4968350.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Distribution of FINDRISC categories by gender. The figures are percentage prevalence of each risk category by gender compared to the total prevalence in each category. Females had significantly higher prevalence of high risk categories than men (<italic>P</italic>-value < 0.001).</p></caption><graphic xlink:href="JDR2016-4968350.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>The receiver operating characteristic (ROC) curves for detecting undiagnosed T2D using FINDRISC and HbA1c (%) among outpatients in Botswana: (a) total population, (b) females, and (c) males. (a–c) Diagonal segments are produced by ties.</p></caption><graphic xlink:href="JDR2016-4968350.003"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>General characteristics of the participants (<italic>N</italic> = 291).</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Participants</th><th align="center" rowspan="1" colspan="1">Total</th><th align="center" rowspan="1" colspan="1">Male</th><th align="center" rowspan="1" colspan="1">Female</th><th align="center" rowspan="1" colspan="1"><italic>P</italic> value</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Age (years ± SD)</td><td align="center" rowspan="1" colspan="1">50.1 (11)</td><td align="center" rowspan="1" colspan="1">50.5 (11.8)</td><td align="center" rowspan="1" colspan="1">49.9 (11.0)</td><td align="center" rowspan="1" colspan="1">0.68</td></tr><tr><td align="left" rowspan="1" colspan="1">Body mass index (kg/m<sup>2</sup> ± SD)</td><td align="center" rowspan="1" colspan="1">28.0 (6.5)</td><td align="center" rowspan="1" colspan="1">24.6 (5.5)</td><td align="center" rowspan="1" colspan="1">29.2 (6.5)</td><td align="center" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">Waist circumference (%) </td><td align="center" rowspan="1" colspan="1"> 72.7 </td><td align="center" rowspan="1" colspan="1"> 34.7 </td><td align="center" rowspan="1" colspan="1"> 85.7</td><td align="center" rowspan="1" colspan="1"><0.01</td></tr><tr><td align="left" rowspan="1" colspan="1">BP systolic (mmHg ± SD)</td><td align="center" rowspan="1" colspan="1">128.6 (19.3) </td><td align="center" rowspan="1" colspan="1">130 (21.1)</td><td align="center" rowspan="1" colspan="1">128 (18.6)</td><td align="center" rowspan="1" colspan="1">0.51</td></tr><tr><td align="left" rowspan="1" colspan="1">BP diastolic (mmHg ± SD)</td><td align="center" rowspan="1" colspan="1">78.5 (12.1)</td><td align="center" rowspan="1" colspan="1">78.6 (11.8)</td><td align="center" rowspan="1" colspan="1">78.4 (12.1)</td><td align="center" rowspan="1" colspan="1">0.9</td></tr><tr><td align="left" rowspan="1" colspan="1">Total FINDRISC (points ± SD)</td><td align="center" rowspan="1" colspan="1">13.2 (5.9)</td><td align="center" rowspan="1" colspan="1">10.1 (5.2)</td><td align="center" rowspan="1" colspan="1">14.3 (5.8)</td><td align="center" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">HbA1c (% ± SD)</td><td align="center" rowspan="1" colspan="1">5.9 (0.76)</td><td align="center" rowspan="1" colspan="1">6.0 (0.6)</td><td align="center" rowspan="1" colspan="1">5.9 (0.8)</td><td align="center" rowspan="1" colspan="1">0.63</td></tr></tbody></table><table-wrap-foot><fn><p>All figures are in means except waist circumference which is proportion (females > 80 cm and males > 94 cm).</p></fn><fn><p>SD = standard deviation. 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