Type 2 Diabetes Risk Calculator

Variables considered

This diabetes risk stratification method contributes to early detection of patients at risk of diabetes or whom suffer from the condition already but are asymptomatic.

The variables used are exemplified in the following table:

As age is one of the main risk factors of type 2 diabetes, the American Diabetes Association (ADA) recommends regular screening after the age of 45.

Risk of diabetes is higher in adult men but with age (after 65) the risk becomes similar in both genders.

Hypertensive patients (blood pressure >135/80 mmHg) carry a greater risk of death and morbidity (up to four times higher) from diabetes related cardiovascular events (including myocardial infarction, stroke, angina).

Corticosteroid therapy recommended to reduce inflammation in several conditions, may trigger diabetes in patients who are already at risk.

Body mass index is used as objective measure for the patient’s weight status. Obese patients carry higher risks.

Early diabetes diagnosis may reduce risk of further tissue damage or cardiovascular conditions.

One of the benefits of this tool relies in the fact that it uses routinely collected information to check whether patients are at risk of diabetes.

Formula

The type 2 diabetes risk calculator uses the following two formulas to generate the diabetes risk percentage:

Terms = 6.322 - Sex - Rx Hypertensive - Rx Steroids - (0.063 x Age) - BMI - Family history - Smoker

Risk = 100 / (1 + e^(Terms))

Depending on the answers provided, the “terms” formula above is populated with different variables, as described in the table below:

About the study

This diabetes risk stratification tool was created by Griffin et al. in 2000, following a study on a population-based sample of 1077 people, aged 40 to 64 years, not known to be suffering of diabetes.

The subjects underwent clinical assessment including an oral glucose tolerance test.

The variables selected were tested in an independent, randomly selected, population-based sample with 72% specificity, 77% sensitivity and a likelihood ratio of 2.76.

The application of this risk stratification method was found to be efficient in early detection of diabetes patients through case-finding or targeted screening.

Diabetes symptoms and diagnosis

Diabetes mellitus is one of the conditions that can go unnoticed for months and years in a row because in some cases is asymptomatic or presents very few symptoms of mild severity.

Some of the diabetes symptoms are:

■ Hyperglycemia;

■ Being very thirsty (polydipsia);

■ Passing more urine (polyuria);

■ Unexplained weight loss;

■ Blurry vision;

■ Poorly healing wounds;

■ Tingling or numbness in hands or feet (paresthesias);

■ Fatigue;

■ Irritability.

Diagnosis includes blood tests that measure blood sugar under different conditions:

■ HbA1C, also known as the glycated hemoglobin test, offers information on blood glucose values over the past 2, 3 months;

■ Fasting plasma glucose is a test that measures blood sugar after eight hours of fast (not drinking or eating anything);

■ Oral glucose tolerance test (OGTT) is aimed at measuring blood glucose before and two hours after a sugary drink.

American Diabetes Association (ADA) has the following guidelines for diagnosis:

■ FPG (fasting plasma glucose) ≥126 mg/dL (7.0 mmol/L) OR;

■ Two-hour plasma glucose level of 200 mg/dL (11.1 mmol/L) or higher during OGTT OR;

■ Random plasma glucose of 200 mg/dL (11.1 mmol/L) in patient with classic symptoms of hyperglycemia or hyperglycemic crisis.

Original source

Griffin SJ, Little PS, Hales CN, Kinmonth AL, Wareham NJ. Diabetes risk score: towards earlier detection of type 2 diabetes in general practice. Diabetes Metab Res Rev. 2000; 16(3):164-71.

Other references

1. Fletcher B, Gulanick M, Lamendola C. Risk factors for type 2 diabetes mellitus. J Cardiovasc Nurs. 2002; 16(2):17-23.

2. Hypertension in Diabetes Study (HDS): II. Increased risk of cardiovascular complications in hypertensive type 2 diabetic patients. J Hypertens. 1993; 1(3):319-25.