Predictive Ability of the Indian Diabetes Risk Score in the Evaluation of Diabetes Risk among Urban Adults of Raipur:...

The Indian Diabetes Risk Score (IDRS) is a cost-effective and noninvasive screening tool that plays an important role in the early detection and risk-stratification of diabetes, and thus immediate referrals to health centers for further assessment and management of the individuals.

The study involved 422 urban adults, aged 30 and older, who came under the field practice area of a tertiary hospital. Using a prevalidated questionnaire, data on sociodemographics, anthropometrics, physical measurement (like blood pressure), biochemical measurement (random blood sugar), and IDRS components were obtained. Univariate and multivariate logistic regression analyses were performed to identify the predictors. The cut-off for the risk score for undiagnosed diabetes risk assessment was evaluated using the area under the curve (AUC) and the receiver-operating characteristic (ROC).

The average age of participants in this study is 46.1 years (±11.8). Out of the total participants, 50.7% were females, while 49.3% were males. According to IDRS, 20.3% of participants were found to be at high risk of diabetes, 56.2% at moderate risk, and 23.5% at low risk. Among the factors that significantly predicted increased diabetes risk according to IDRS were age, high salt consumption, female gender, and higher body mass index. With a 0.68 AUC, the IDRS exhibited an 86.6% sensitivity at a cut-off value of ≥30 and a 28.1% specificity. The study observed maximum sensitivity (60.6%) and specificity (69.5%) at a cut-off of 45, as further shown by evaluating Youden's index (30.1%).

With optimal performance at a cut-off of ≥45, the IDRS reasonably identified 76.5% of urban adults with moderate-to-high risk for diabetes. Integration of routine IDRS screening in primary healthcare in resource-limited settings, along with counseling on lifestyle modification, can increase its utility in risk stratification and referral.