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Determining the optimal screening interval for type 2 diabetes mellitus using a risk prediction model
Andrei Brateanu1, Thomas Barwacz2, Lei Kou3
1Medicine Institute, Cleveland Clinic, Cleveland OH, United States of America.
Plos One
|November 15, 2017
Summary
This study developed a diabetes mellitus (DM) risk prediction model to personalize screening intervals. Patients at high risk can be screened sooner, improving early detection and management of diabetes.
Area of Science:
- Endocrinology
- Preventive Medicine
- Biostatistics
Background:
- Diabetes mellitus (DM) progression is variable, and optimal screening intervals lack robust evidence.
- Current guidelines suggest 3-year screening intervals, but this is based on limited data.
- A need exists for a more personalized approach to DM screening.
Purpose of the Study:
- To develop a predictive model for diabetes mellitus onset.
- To establish risk-based screening intervals for DM detection.
- To utilize readily available clinical data for risk stratification.
Main Methods:
- Utilized Cox proportional hazards models on data from 5084 non-diabetic adult patients.
- Included patients with at least two glycated hemoglobin (HbA1c) measurements between 2008 and 2013.
- Defined DM as HbA1c > 6.4% (46 mmol/mol) for outcome determination.
Main Results:
- Within 5 years, 4.4% of normal HbA1c and 27.5% of prediabetes patients developed DM.
- Key predictors included HbA1c, family history, smoking, triglycerides, ALT, BMI, age, and HDL.
- Highest risk tertile developed DM in 8 months; intermediate in 35 months; lowest tertile had 2.4% incidence over 5 years.
Conclusions:
- A risk prediction model using common clinical data can guide personalized DM screening intervals.
- High-risk individuals may benefit from screening as early as 8 months.
- Intermediate and low-risk groups could be screened at 3 and 5 years, respectively.
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