Author/Editor		Štiglic, Gregor; Kocbek, Primož; Cilar, Leona; Fijačko, Nino; Stožer, Andraž; Zaletel, Jelka; Sheikh, Aziz; Povalej Bržan, Petra
Title		Development of a screening tool using electronic health records for undiagnosed Type 2 diabetes mellitus and impaired fasting glucose detection in the Slovenian population
Type		članek
Vol. and No.		Letnik 35, št. 5
Publication year		2018
Volume		str. 640-649
ISSN		0742-3071 - Diabetic medicine : a journal of the British Diabetic Association
Language		eng
Abstract		AIM: To develop and validate a simplified screening test for undiagnosed Type 2 diabetes mellitus and impaired fasting glucose for the Slovenian population (SloRisk) to be used in the general population. METHODS: Data on 11 391 people were collected from the electronic health records of comprehensive medical examinations in five Slovenian healthcare centres. Fasting plasma glucose as well as information related to the Finnish Diabetes Risk Score questionnaire, FINDRISC, were collected for 2073 people to build predictive models. Bootstrapping-based evaluation was used to estimate the area under the receiver-operating characteristic curve performance metric of two proposed logistic regression models as well as the Finnish Diabetes Risk Score model both at recommended and at alternative cut-off values. RESULTS: The final model contained five questions for undiagnosed Type 2 diabetes prediction and achieved an area under the receiver-operating characteristic curve of 0.851 (95% CI 0.850-0.853). The impaired fasting glucose prediction model included six questions and achieved an area under the receiver-operating characteristic curve of 0.840 (95% CI 0.839-0.840). There were four questions that were included in both models (age, sex, waist circumference and blood sugar history), with physical activity selected only for undiagnosed Type 2 diabetes and questions on family history and hypertension drug use selected only for the impaired fasting glucose prediction model. CONCLUSION: This study proposes two simplified models based on FINDRISC questions for screening of undiagnosed Type 2 diabetes and impaired fasting glucose in the Slovenian population. A significant improvement in performance was achieved compared with the original FINDRISC questionnaire. Both models include waist circumference instead of BMI.
Keywords		undiagnosed type 2 diabetes mellitus screening fasting plasma glucose prevention