Efficacy of Qingdao diabetes risk score in type 2 diabetes mellitus screening among asymptomatic adult populations

Objective To evaluate the efficacy of Qingdao diabetes risk score (QDRS) in type 2 diabetes mellitus (T2DM) screening among symptomatic adult residents and to provide references for T2DM prevention and control. Methods A diabetes control project was conducted among 4 426 self-assessed healthy persons aged 35-74 years in Qingdao city of Shandong province;questionnaire surveys including Chinese diabetes risk score (CDRS), QDRS and a general questionnaire, physical examination, and laboratory test including oral glucose tolerance test (OGTT) and fasting plasma glucose (FPG) were performed among the attendees of the project.Then a follow-up study the same as the previous project was conducted in 2012 among 3 843 attendees who were not diagnosed with T2DM in 2009, of which, 2 295 were followed up finally.Receiver operating characteristic (ROC) curve was constructed and the sensitivity, specificity, and Youden indexe were calculated for QDRS, CDRS, and FPG to evaluate the efficacy of the indexes in screening asymptomatic diabetes. Results The detection rate of T2DM was 13.2% among the 4 426 participants of the survey in 2009 and 7.9% among the 2 295 participants of follow-up study in 2012.Based on the data of 2009 survey, the area under the ROC curve (AUC) of FPG, QDRS, and CDRS for T2DM detection were 0.87 (95% confidence interval95%CI=0.85-0.89), 0.87 (95%CI=0.85-0.89), and 0.70 (95%CI=0.68-0.72);the sensitivity and specificity of the optimal cut-off value of FPG (≥6.4 mmol/L), QDRS (≥14 points), and CDRS (≥30 points) were 72.0% and 91.2%, 73.2% and 66.5%, and 66.2% and 63.8%, respectively;the Youden' index for FPG, QDRS, and CDRS were 0.63, 0.30, and 0.30.Based on the data of 2012 follow-up study, the AUC of FPG, QDRS, and CDRS were 0.83 (95%CI=0.79-0.87), 0.62 (95%CI=0.57-0.66), and 0.65 (95%CI=0.61-0.70);the sensitivity and specificity of the optimal cut-off value of FPG, QDRS, and CDRS were 51.7% and 95.7%, 75.6% and 41.0%, and 73.8% and 47.9%, respectively;the Youdenindex for FPG, QDRS, and CDRS were 0.47, 0.12, and 0.21.There were no significant differences in the efficacy of QDRS and FPG, CDRS for predicting T2DM incidence between 2009 survey and 2012 follow-up study(P > 0.05 for all). Conclusion QDRS could be used as a reliable screening tool for T2DM screening among healthy adult populations.