1
|
Liu Y, Yu S, Feng W, Mo H, Hua Y, Zhang M, Zhu Z, Zhang X, Wu Z, Zheng L, Wu X, Shen J, Qiu W, Lou J. A meta-analysis of diabetes risk prediction models applied to prediabetes screening. Diabetes Obes Metab 2024; 26:1593-1604. [PMID: 38302734 DOI: 10.1111/dom.15457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 02/03/2024]
Abstract
AIM To provide a systematic overview of diabetes risk prediction models used for prediabetes screening to promote primary prevention of diabetes. METHODS The Cochrane, PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) databases were searched for a comprehensive search period of 30 August 30, 2023, and studies involving diabetes prediction models for screening prediabetes risk were included in the search. The Quality Assessment Checklist for Diagnostic Studies (QUADAS-2) tool was used for risk of bias assessment and Stata and R software were used to pool model effect sizes. RESULTS A total of 29 375 articles were screened, and finally 20 models from 24 studies were included in the systematic review. The most common predictors were age, body mass index, family history of diabetes, history of hypertension, and physical activity. Regarding the indicators of model prediction performance, discrimination and calibration were only reported in 79.2% and 4.2% of studies, respectively, resulting in significant heterogeneity in model prediction results, which may be related to differences between model predictor combinations and lack of important methodological information. CONCLUSIONS Numerous models are used to predict diabetes, and as there is an association between prediabetes and diabetes, researchers have also used such models for screening the prediabetic population. Although it is a new clinical practice to explore, differences in glycaemic metabolic profiles, potential complications, and methods of intervention between the two populations cannot be ignored, and such differences have led to poor validity and accuracy of the models. Therefore, there is no recommended optimal model, and it is not recommended to use existing models for risk identification in alternative populations; future studies should focus on improving the clinical relevance and predictive performance of existing models.
Collapse
Affiliation(s)
- Yujin Liu
- Nursing Department, The second Hosiptal of Jinhua, Jinhua, China
- School of Medicine, Huzhou University, Huzhou, China
| | - Sunrui Yu
- Department of Anesthesiology, Jinhua Municipal Central Hospital, Jinhua, China
| | | | - Hangfeng Mo
- School of Medicine, Huzhou University, Huzhou, China
| | - Yuting Hua
- School of Medicine, Huzhou University, Huzhou, China
| | - Mei Zhang
- School of Medicine, Huzhou University, Huzhou, China
| | - Zhichao Zhu
- School of Medicine, Huzhou University, Huzhou, China
- Emergency Department, Jinhua Municipal Central Hospital Medical Group, Jinhua, China
| | - Xiaoping Zhang
- Nursing Department, The second Hosiptal of Jinhua, Jinhua, China
| | - Zhen Wu
- Nursing Department, The second Hosiptal of Jinhua, Jinhua, China
| | - Lanzhen Zheng
- Nursing Department, The second Hosiptal of Jinhua, Jinhua, China
| | - Xiaoqiu Wu
- Nursing Department, The second Hosiptal of Jinhua, Jinhua, China
| | - Jiantong Shen
- School of Medicine, Huzhou University, Huzhou, China
| | - Wei Qiu
- Department of Endocrinology, Huzhou Central Hospital, Huzhou, China
| | - Jianlin Lou
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, China
| |
Collapse
|
2
|
Reed T, Scott S, Grewal E, Macavinta F, Tariq S, Campbell DJT. Estimating the Rates of Undiagnosed Prediabetes and Diabetes Among People Experiencing Homelessness. Can J Diabetes 2024:S1499-2671(24)00066-2. [PMID: 38582226 DOI: 10.1016/j.jcjd.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/29/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVES The rising prevalence of type 2 diabetes (T2D) in Canada poses a significant health challenge. Despite the convenience of screening for diabetes with glycated hemoglobin concentration, people experiencing homelessness (PEH) often face barriers to accessing diabetes screening, potentially leading to underdiagnosis. In this study, we aim to assess the prevalence of undiagnosed diabetes among PEH in Calgary, Alberta, and contribute insights for planning healthcare services and public health initiatives. METHODS Four screening clinics were held, and participants were recruited through posters and word of mouth. Participants underwent point-of-care glycated hemoglobin (A1C) testing using the Siemens DCA Vantage point-of-care analyzer. Descriptive statistics were used to identify the proportions of prediabetes and diabetes, whereas CanRisk survey scores were used to identify the pre-test probability of diabetes. RESULTS The mean age of participants (n=102) was 47.6 years, and the self-reported causes of homelessness among the participants were diverse, including: housing and financial issues (n=53), interpersonal and family issues (n=35), and health or corrections-related factors (n=27). The average A1C was 5.60% (standard deviation 0.57%), with 5 values in the diabetes range and 12 in the prediabetes range, for a total of 17 participants found to have previously undiagnosed dysglycemia. CONCLUSIONS The high rate of undiagnosed prediabetes and diabetes among people experiencing homelessness reflects at least what is already seen in the general population in Canada. More resources are required to reduce the barriers to screening for diabetes among this population.
Collapse
Affiliation(s)
- Tucker Reed
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sara Scott
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Eshleen Grewal
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Fatima Macavinta
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Calgary Drop-In Centre, Calgary, Alberta, Canada
| | - Saania Tariq
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David J T Campbell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| |
Collapse
|
3
|
Bamogaddam RF, Mohzari Y, Aldosari FM, Alrashed AA, Almulhim AS, Kurdi S, Alohaydib MH, Alotaibi OM, Alotaibi AZ, Alamer A. Prevalence and Associations of Type 2 Diabetes Risk and Sociodemographic Factors in Saudi Arabia: A Web-Based Cross-Sectional Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2269. [PMID: 36767635 PMCID: PMC9916295 DOI: 10.3390/ijerph20032269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic disease with ever-increasing prevalence worldwide. In our study, we evaluated the prevalence of the risk of developing T2DM in Saudi Arabia and investigated associations between that risk and various sociodemographic characteristics. To those ends, a web-based cross-sectional survey of Saudi nationals without diabetes, all enrolled using snowball sampling, was conducted from January 2021 to January 2022. The risk of developing T2DM was evaluated using a validated risk assessment questionnaire (ARABRISK), and associations of high ARABRISK scores and sociodemographic variables were explored in multivariable logistic regression modeling. Of the 4559 participants, 88.1% were 18 to 39 years old, and 67.2% held a college or university degree. High ARABRISK scores were observed in 7.5% of the sample. Residing in a midsize city versus a large city was associated with a lower ARABRISK risk score (p = 0.007), as were having private instead of governmental insurance (p = 0.005), and being unemployed versus employed (p < 0.001). By contrast, being married (p < 0.001), divorced or widowed (p < 0.001), and/or retired (p < 0.001) were each associated with a higher ARABRISK score. A large representative study is needed to calculate the risk of T2DM among Saudi nationals.
Collapse
Affiliation(s)
- Reem F. Bamogaddam
- Department of Clinical Pharmacy, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Yahya Mohzari
- Department of Clinical Pharmacy, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Fahad M. Aldosari
- Department of Clinical Pharmacy, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ahmed A. Alrashed
- Department of Pharmacy, King Fahad Medical City, Riyadh 11564, Saudi Arabia
| | - Abdulaziz S. Almulhim
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Sawsan Kurdi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Munirah H. Alohaydib
- Department of Pharmaceutical Services, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ohoud M. Alotaibi
- Department of Pharmaceutical Services, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Amani Z. Alotaibi
- Department of Pharmaceutical Services, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ahmad Alamer
- Department of Clinical Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 16273, Saudi Arabia
| |
Collapse
|
4
|
Bird M, Cerutti S, Jiang Y, Srugo SA, de Groh M. Implementation of the CANRISK Tool: A Qualitative Exploration Among Allied Health Professionals in Canada. Can J Diabetes 2021; 46:118-125. [PMID: 34334307 DOI: 10.1016/j.jcjd.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/28/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Launched in 2011 by the Public Health Agency of Canada, the Canadian Diabetes Risk Questionnaire (CANRISK) is a self-assessment tool validated in a Canadian sample, but its uptake has never been assessed. We sought to determine the level of current use of the CANRISK tool, identify common facilitators and barriers to its use and recommend future improvements. METHODS Ten professional allied health organizations across Canada were contacted for in-depth interviews. Contextual content and thematic analysis were used to analyze the qualitative data set. RESULTS According to allied health professionals, the tool is widely used, appealing and needed, and is being used for risk screening and health promotion. Respondents also identified the need to provide support and next steps for users identified as high risk. Still, several barriers to implementation were found, including readability, offensive or confusing language and difficulty ascertaining body measurements. CONCLUSIONS The CANRISK is a valuable diabetes risk assessment tool in Canada, particularly for allied health organizations.
Collapse
Affiliation(s)
- Madeleine Bird
- Social Determinants of Health Division, Public Health Agency of Canada, Montréal, Québec, Canada; Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Stephanie Cerutti
- Ontario Regional Office, Public Health Agency of Canada, Toronto, Ontario, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Sebastian A Srugo
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
| |
Collapse
|