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Risk prediction models for incident type 2 diabetes: s scoping review and an update to a systematic review
Raha Amirvala1, Farzad Hadaegh1, Davood Khalili1
1Prevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract:
Early identification of high-risk individuals is key for type 2 diabetes prevention. This study combines a scoping review of historical risk prediction models with a systematic review update of recent models (2019-2026) to map methodological evolution, geographical trends, and reporting quality. PubMed was searched for existing systematic reviews (1993-January 2026) for the scoping review, and for new primary studies (November 2019-January 2026) to update prior evidence. Original English-language regression-based prediction models for incident type 2 diabetes in adults were included; validation studies, machine-learning models, and non-original publications were excluded. Data were synthesised narratively and descriptively, with quality assessed using CHARMS, TRIPOD, and PROBAST. The scoping review synthesised 50 primary studies (median n = 5,217; follow-up 7 years); internal validation was reported in 84.0% versus 16.0% external, and AUC in 90.0%. The systematic update identified 20 new studies (median n = 8,879; follow-up 8.7 years); internal and external validation were respectively reported in 55.0% and 50.0%, calibration in 75.0%, and AUC in 75.0%. Risk of bias remained high in 70.0% of updated studies. Discrimination reporting is now standard, but external validation, calibration, and risk-of-bias reporting remain inconsistent. Future models should prioritise external validation and evaluation in diverse populations before clinical implementation.