Use of the FINDRISC Questionnaire in the Uzbek Population as a First Stage of Screening for Type 2 Diabetes Mellitus

ORIGINAL ARTICLE
Anna V. Alieva, Saydiganikhodja I. Ismailov, Gulnara N. Rakhimova

 
International Journal of Biomedicine. 2020;10(1):24-28.
DOI: 10.21103/Article10(1)_OA3
Originally published March 15, 2020

Abstract: 

Background: Active diagnosis of rapidly growing type 2 diabetes (T2D) is very important. Whether the FINDRISC questionnaire can be used as a first-stage screening tool in the Uzbek population is unclear, as anthropometric parameters and the impact of each risk factor may differ in different populations.
Materials and Results: In 2015–2016, regardless of nationality 2521 people (711 men and 1464 women) living in urban and rural areas of Uzbekistan were examined. The study included filling out a FINDRISC questionnaire with an assessment of the risk for T2D. All subjects underwent OGTT and HbA1c testing. The average score on the FINDRISC questionnaire among people with newly diagnosed diabetes was 12.8±0.4 (P<0.001), for IGT – 11.4±0.4 (P<0.001), for IFG – 11.0±0.8 (P<0.001) compared with individuals without carbohydrate metabolism disorders (8.0±0.09). Among people with diabetes diagnosed during the screening, only 33.9% had a high (30%) and very high (3.9%) risk of T2D, while 27.6% had a moderate risk, 30% - an increased risk, and 8.7% - a low risk of T2D. For the FINDRISC score, the sensitivity with a threshold value of 9 points was 87.9% and specificity was 45.3%; with a value of 12 points, sensitivity was 71.6% and specificity was 54.8%.
Conclusion: These results were the basis for a multivariate analysis of the risk for T2D among people of Uzbek nationality, and for the development of our own risk assessment program.

Keywords: 
type 2 diabetes • screening • ethnicity • risk assessment
References: 
  1. IDF Diabetes Atlas, Seventh Edition, 2015.
  2. Beagley J, Guariguata L, Weil C, Motala AA. Global estimates of undiagnosed diabetes in adults. Diabetes Res Clin Pract. 2014 Feb;103(2):150-60. doi: 10.1016/j.diabres.2013.11.001.
  3. IDF Clinical Practice Recommendations for Managing Type 2 Diabetes in Primary Care. International Diabetes Federation 2017.
  4. Li R, Zhang P, Barker LE, Chowdhury FM, Zhang X. Cost-effectiveness of interventions to prevent and control diabetes mellitus: a systematic review. Diabetes Care. 2010 Aug;33(8):1872-94. doi: 10.2337/dc10-0843.
  5. The WHO STEPwise approach to Surveillance of noncommunicable diseases (STEPS). World Health Organization 2003.
  6. A call to Action on Diabetes. International Diabetes Federation, Belgium, November, 2010. Available at: https://www.yumpu.com/en/document/read/6749334/call-to-action-on-diabete...
  7. Lindstrom J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care, 2003;26(3):725–31.
  8. Saaristo T, Peltonen M, Lindstrom J, Saarikoski L, Sundvall J. Eriksson JG et al. Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome. Diab Vasc Dis Res. 2005;2(2):67–72.
  9. American Diabetes Association Standards of Medical Care in Diabetes – 2018. Diabetes Care. 2018;41(Supp l):S2–S159.
  10. The Canadian Diabetes Risk Questionnaire CANRISK. Public Health Agency of Canada -2013.
  11. The Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Australian Government. Department of Health and Aging. Canberra, 2010.
  12. Wang A, Chen G, Su Zh, Liu X, Li H, Luo Ya, et al. Risk scores for predicting incidence of type 2 diabetes in the Chinese population: the Kailuan prospective study. Sci Rep. 2016 May 25;6:26548. doi: 10.1038/srep26548.
  13. Heianza Y, Arase Y, Saito K, Hseih SD, Tsuji H, Kodama S et al. Development of a Screening Score for Undiagnosed Diabetes and Its Application in Estimating Absolute Risk of Future Type 2 Diabetes in Japan: Toranomon Hospital Health Management Center Study 10 (TOPICS 10). J Clin Endocrinol Metab. 2013 Mar;98(3):1051-60. doi: 10.1210/jc.2012-3092.
  14. Nanri A, Nakagava T, Kuwahara K, Yamamoto S, Honda T, Okazaki H et al. Development of Risk Score for Predicting 3-Year Incidence of Type 2 Diabetes: Japan Epidemiology Collaboration on Occupational Health Study. PLoS One. 2015 Nov 11;10(11):e0142779. doi: 10.1371/journal.pone.0142779.
  15. Bernabe-Ortiz A, Smeeth L, Gilman RH, Sanchez-Abanto JR, Checkley W, Miranda JJ, Study Group CC. Development and Validation of a Simple Risk Score for Undiagnosed Type 2 Diabetes in a Resource-Constrained Setting. J Diabetes Res. 2016;2016: 8790235.
  16. Omech B, Mwita JC, Tshikuka JG, Tsima B, Nkomazna O, Amone-P’Olak K. Validity of the Finnish Diabetes Risk Score for Detecting Undiagnosed Type 2 Diabetes among General Medical Outpatients in Botswana. J Diabetes Res. 2016; 2016:4968350.
  17. Robinson T, Elley CR, Wells S, Robinson E, Kenealy T, Pylypchuk R et al. New Zealand Diabetes Cohort Study cardiovascular risk score for people with type 2 diabetes: validation in the PREDICT cohort. J Prim Health Care. 2012;4(3):181-8.
  18. Silvestre MP, Jiang Y, Volkova K, Chisholm H, Lee W, Poppitt SD. Evaluating FINDRISC as a screening tool for type 2 diabetes among overweight adults in the PREVIEW:NZ cohort. Prim Care Diabetes. 2017 Dec;11(6):561-569. doi: 10.1016/j.pcd.2017.07.003.
  19. Recommendations on diabetes, prediabetes and cardiovascular diseases. EASD/ESC. Russian Journal of Cardiology. 2014;107(3):6–70. (in Russian)
  20. Ismailov SI, Rakhimova GN, Alieva AV. Anthropometric reference data for Uzbek women. International Journal of Biomedicine. 2017;7(2):120-125.
  21. Alieva AV, Ismailov SI, Rakhimova GN, Akbarov ZS. Anthropometric references for men of Uzbek nationality. NJDIS. 2017;(8):41-44.
  22. WHO global strategy on diet, physical activity and health: European regional consultation meeting report. World Health Organization 2003. Available at: https://www.who.int/dietphysicalactivity/media/en/gscon_cs_report_euro.pdf
  23. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Report of a WHO/IDF consultation, 2006. Available at: https://www.who.int/diabetes/publications/diagnosis_diabetes2006/en/
  24. Olamoyegun AM, Oluyombo R, Iwuala OS. The Performance of the Finnish Diabetes Risk Score (FINDRISC) Questionaire for Screening Individuals with Undiagnosed Type 2 Diabetes and Dysglycaemia in Nigeria. Br British Journal of Medicine & Medical Research. 2017;19(5):1-8.  DOI: 10.9734/BJMMR/2017/31022
  25. Gomez-Arbelaez D, Alvarado-Jurado L, Avala-Castillo M, Forero-Naranjo L, Camacho PA, Lopez-Jaramillo P. Evaluation of the Finnish Diabetes Risk Score to predict type 2 diabetes mellitus in a Colombian population: A longitudinal observational study. World J Diabetes. 2015 Dec 10;6(17):1337-44. doi: 10.4239/wjd.v6.i17.1337.
  26. Salinero-Fort MA, Burgos-Lunar C, Lahoz C, Mostaza JM, Abanades-Herranz JC, Laguna-Cuesta F et al. Performance of the Finnish Diabetes Risk Score and a Simplified Finnish Diabetes Risk Score in a Community-Based, Cross-Sectional Programme for Screening of Undiagnosed Type 2 Diabetes Mellitus and Dysglycaemia in Madrid, Spain: The SPREDIA-2 Study. PLoS One. 2016 Jul 21;11(7):e0158489. doi: 10.1371/journal.pone.0158489.
  27. Makrilakis K, Liatis S, Grammatikou S, Perrea D, Stathi C, Tsiligros P et al. Validation of the Finnish diabetes risk score (FINDRISC) questionnaire for screening for undiagnosed type 2 diabetes, dysglycaemia and the metabolic syndrome in Greece. Diabetes Metab. 2011 Apr;37(2):144-51. doi: 10.1016/j.diabet.2010.09.006.
  28. Li J, Bergmann A, Reimann M, Bornstein SR, Schwarz PE. A more simplified Finnish diabetes risk score for opportunistic screening of undiagnosed type 2 diabetes in a German population with a family history of the metabolic syndrome. Horm Metab Res. 2009 Feb;41(2):98-103. doi: 10.1055/s-0028-1087191.
  29. American Diabetes Association. Classification and Diagnosis of Diabetes. Diabetes Care. 2017;40 (Supp 1):S11–S24.
  30. Alieva AV, Rakhimova GN, Ismailov SI, Akbarov ZS. Assessment of risk for impaired glucose tolerance and type 2 diabetes mellitus in people of Uzbek nationality. Manual. Tashkent; 2017. [In Russian].

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Received January 25, 2020.
Accepted February 20, 2020.
©2020 International Medical Research and Development Corporation.