The utility of diabetes risk score items as predictors of incident type 2 diabetes in Asian populations: An evidence-based review

Abstract

Background: The prevalence of type 2 diabetes mellitus is rising, with many Asian countries featured in the top 10 countries with the highest numbers of persons with diabetes. Reliable diabetes risk scores enable the identification of individuals at risk of developing diabetes for early intervention.

Objectives: This article aims to identify common risk factors in the risk scores with the highest discrimination; factors with the most influence on the risk score in Asian populations, and to propose a set of factors translatable to the multi-ethnic Singapore population.

Methods: A systematic search of PubMed and EMBASE databases was conducted to identify studies published before August 2016 that developed risk prediction models for incident diabetes.

Results: 12 studies were identified. Risk scores that included laboratory measurements had better discrimination. Coefficient analysis showed fasting glucose and HbA1c having the greatest impact on the risk score.

Conclusion: A proposed Asian risk score would include: family history of diabetes, age, gender, smoking status, body mass index, waist circumference, hypertension, fasting plasma glucose, HbA1c, HDL-cholesterol and triglycerides. Future research is required on the influence of ethnicity in Singapore. The risk score may potentially be used to stratify individuals for enrolment into diabetes prevention programmes.

Keywords: Asia; Incidence; Risk assessment; Risk score; Type 2 diabetes mellitus.