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A novel predictive model for optimizing diabetes screening in older adults.
Yushuang Lin1, Ya Shen2, Rongbo He3
1Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China.
Journal of Diabetes Investigation
|July 11, 2024
Summary
A new nomogram effectively predicts diabetes risk in older adults with normal fasting glucose. This tool can improve early diabetes detection and screening efficiency in primary care settings.
Area of Science:
- Gerontology
- Endocrinology
- Preventive Medicine
Background:
- Fasting blood glucose tests are standard for diabetes screening but may miss early stages with elevated postprandial glucose.
- Early detection of diabetes is crucial, especially in older adults where symptoms can be subtle.
Purpose of the Study:
- To develop and validate a nomogram for predicting diabetes risk in older adults who have normal fasting glucose levels.
- To improve the accuracy and efficiency of diabetes screening in primary healthcare settings.
Main Methods:
- A cohort of 2,235 older adults was divided into training (n=1,564) and validation (n=671) sets.
- Least Absolute Shrinkage and Selection Operator (LASSO) regression identified key predictors for nomogram construction.
- Nomogram performance was assessed using calibration, discrimination (AUC), and decision curve analysis.
Main Results:
- Nine significant predictors were identified: age, gender, BMI, fasting glucose, triglycerides, ALT, AST/ALT ratio, BUN, and hemoglobin.
- The nomogram showed good discrimination with an Area Under the Curve (AUC) of 0.824 (Training Set) and 0.809 (Validation Set).
- Calibration curves confirmed the nomogram's accuracy in estimating diabetes risk, and decision curve analysis supported its clinical utility.
Conclusions:
- A dynamic nomogram was developed to identify older adults at high risk for diabetes.
- This tool has the potential to enhance the efficiency of diabetes screening in primary healthcare.
- The nomogram offers a valuable approach for early diabetes risk assessment in older populations.
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