Validation of the diabetes screening tools proposed by the American Diabetes Association in an aging Chinese population

• Published in: PloS one 2017-09, Vol.12 (9), p.e0184840-e0184840
• Main Authors: Woo, Yu Cho, Lee, Chi Ho, Fong, Carol H Y, Tso, Annette W K, Cheung, Bernard M Y, Lam, Karen S L
• Format: Article
• Language: English
• Subjects: Aged; Aging; Analysis; Area Under Curve; Asian Americans; Biology and Life Sciences; Blood Glucose - analysis; Blood glucose test; Body mass; Body mass index; Brain research; Cardiovascular diseases; China - epidemiology; Criteria; Diabetes; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diagnosis; Diagnostic systems; Diagnostic tests; Family medical history; Fasting; Female; Glucose; Glucose tolerance; Glucose Tolerance Test - methods; Health care; Health risk assessment; Health risks; Health screening; Hemoglobin; Humans; Intervention; Laboratory testing; Likelihood ratio; Male; Mass Screening - methods; Medical diagnosis; Medicine; Medicine and Health Sciences; Middle Aged; People and places; Population; Prevalence; Public health; Quality management; Risk analysis; Risk factors; Screening; Sensitivity and Specificity; Type 2 diabetes; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0184840

Diabetes is a serious global health problem. A simple and effective screening tool should have substantial public health benefit. We investigated the performance of the latest American Diabetes Association diabetes screening methods in our aging Chinese population. Subjects without diabetes who returned for the 4th Hong Kong Cardiovascular Risk Factors Prevalence Study in 2010-2012 were evaluated for the probability of having diabetes with reference to the age- and body mass index-based screening criteria (screening criteria) and the diabetes risk test (risk test), and the conclusion drawn was compared to their measured glycaemic status. Diabetes was defined by fasting glucose ≥ 7 mmol/L or 2-hour post oral glucose tolerance test glucose ≥ 11.1 mmol/L. 1415 subjects, aged 58.1±10.2, were evaluated. 95 (6.7%) had diabetes. The risk test showed good accuracy (area under the receiver operating curve 0.725) in screening for diabetes with an optimal cut-off score of five. Compared to the screening criteria, the risk test had significantly better specificity (0.57 vs. 0.41, p