A Simple Screening Score for Diabetes for the Korean Population

Abstract

OBJECTIVE We developed and validated a self-assessment score for diabetes risk in Korean adults and compared it with other established screening models. RESEARCH DESIGN AND METHODS The Korea National Health and Nutrition Examination Survey (KNHANES) 2001 and 2005 data were used to develop a diabetes screening score. After excluding patients with known diabetes, 9,602 participants aged ≥20 years were selected. Undiagnosed diabetes was defined as a fasting plasma glucose ≥126 mg/dL and/or nonfasting plasma glucose ≥200 mg/dL. The SAS Survey Logistic Regression analysis was used to determine predictors of undiagnosed diabetes (n = 341). We validated our model and compared it with other existing methods using the KNHANES 2007–2008 data (n = 8,391). RESULTS Age, family history of diabetes, hypertension, waist circumference, smoking, and alcohol intake were independently associated with undiagnosed diabetes. We calculated a diabetes screening score (range 0–11), and a cut point of ≥5 defined 47% of adults as being at high risk for diabetes and yielded a sensitivity of 81%, specificity of 54%, positive predictive value of 6%, and positive likelihood ratio of 1.8 (area under the curve [AUC] = 0.73). Comparable results were obtained in validation datasets (sensitivity 80%, specificity 53%, and AUC = 0.73), showing better performance than other non-Asian models from the U.S. or European population. CONCLUSIONS This self-assessment score may be useful for identifying Korean adults at high risk for diabetes. Additional studies are needed to evaluate the utility and feasibility of this score in various settings.