Related Experiment Video
Updated: Sep 2, 2025
A High-Throughput Electrochemiluminescence 7-Plex Assay Simultaneously Screening for Type 1 Diabetes and Multiple Autoimmune Diseases
Published on: May 29, 2020
German Diabetes Risk Score for the Determination of the Individual Type 2 Diabetes Risk—10-Year Prediction and
Catarina Schiborn1, Rebecca Paprott, Christin Heidemann
1Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal; German Center for Diabetes Research (DZD), Munich; Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), Berlin; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg; Institute for Global Food Security, Queen's University Belfast, Belfast, UK; Department of Medicine IV, University Hospital Tübingen; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen; Institute of Nutritional Science, University of Potsdam, Nuthetal.
Background:
The German Diabetes Risk Score (GDRS) currently enables prediction of the individual risk of developing type 2 diabetes (T2D) within five years. The aim of this study is to extend the prediction period of the GDRS, including its non-clinical version and its HbA1c extension, to 10 years, and to perform external validation.
Methods:
In data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study (n = 25 393), Cox proportional hazards regression was used to reweight the points that were used to calculate the five-year risk. Two population-based prospective cohorts (EPIC-Heidelberg n = 23 624, GNHIES98 cohort n = 3717) were used for external validation. Discrimination was represented by C-indices, and calibration by calibration plots and the expected-to-observed (E/O) ratio.
Results:
Prediction performance in EPIC-Potsdam was very good (C-index for the non-clinical model: 0.834) and was confirmed in EPIC-Heidelberg (0.843) and in the GNHIES98 cohort (0.851). Among persons in the GNHIES98 cohort with a greater than 10% predicted probability of disease, 14.9% developed T2D within 10 years (positive predictive value). The models were very well calibrated in EPIC-Potsdam (E/O ratio for the non-clinical model: 1.08), slightly overestimated the risk in EPIC-Heidelberg (1.34), and predicted T2D very well in the GNHIES98 cohort after recalibration (1.06).
Conclusion:
The extended GDRS prediction period of 10 years, with a non-clinical version and an HbA1c extension that will soon be available in both German and English, enables the even longer-range, evidence-based identification of high-risk individuals with many different applications, including medical screening.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:36Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...