Evaluation of Diabetes Risk Score Tool for Detecting Undiagnosed Type 2 Diabetes Mellitus in Referral Clinics at Primary Health Care Centers in Sudan: a Cross-sectional Study

Abstract

INTRODUCTION: The prevalence of diabetes in Sudan is increasing, but suitable risk assessment and screening tools to identify at-risk individuals are lacking. OBJECTIVE: To evaluate the Diabetes Risk Score (DRS) tool for detecting undiagnosed type 2 diabetes mellitus. METHODS: In this cross-sectional study, 214 individuals were recruited from primary health care referral centers in Khartoum State. Attendees were interviewed to fill out the DRS questionnaire. Random blood glucose and glycosylated hemoglobin (HbA1c) were tested. Descriptive statistics and sensitivity analyses were used to test the applicability of the DRS in Sudan. RESULTS: The prevalence of undiagnosed Type 2 diabetes was found to be 14%. Regarding blood tests, random blood glucose was normal in 93% of the participants (cutoff: ≤140 mg/dl). The HbA1c result was normal in 86% of the participants (cutoff: < 6.4%). The DRS was high in 40.2% (cutoff: ≥33), while 59.8% were considered to have moderate to low risk. The DRS had a sensitivity of 83.33% and a specificity of 66.85%. The positive and negative predictive values were 29.07% and 96.09%, respectively. The area under the curve (AUC) for detecting undiagnosed Type 2 diabetes was 0.751 (95% confidence interval: 0.662-0.840). CONCLUSION: The DRS tool was found to be applicable with reference to the HbA1c test for predicting undiagnosed Type 2 diabetes.