Lindstrom and Tuomilehto developed a risk score for identifying patients at risk for development of type 2 diabetes mellitus. This can help identify patients who should be monitored more closely and who can be targeted for preventive interventions. The authors are from the University of Helsinki in Finland.
Patient selection: adults 25 to 64 years of age
Parameters:
(1) age
(2) body mass index (BMI)
(3) gender and waist circumference in centimeters
(4) use of blood pressure medication
(5) history of high blood glucose
(6) physical activity in hours per week
(7) daily consumption of vegetables, fruits or berries
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 45 years of age
|
0
|
|
|
45 - 54 years of age
|
2
|
|
|
55 - 64 years of age
|
3
|
|
body mass index (BMI)
|
<= 25 kg per square meter
|
0
|
|
|
25.01 to 30 kg per square meter
|
1
|
|
|
> 30 kg per square meter
|
3
|
|
waist circumference in cm
|
male and < 94 cm
|
0
|
|
|
male and 94 - 101.99 cm
|
3
|
|
|
male and >= 102 cm
|
4
|
|
|
female and < 80 cm
|
0
|
|
|
female and 80 to 87.99 cm
|
3
|
|
|
female and >= 88 cm
|
4
|
|
use of blood pressure medications
|
no
|
0
|
|
|
yes
|
2
|
|
history of high blood glucose
|
no
|
0
|
|
|
yes
|
5
|
|
physical activity
|
< 4 hours per week
|
2
|
|
|
>= 4 hours per week
|
0
|
|
consumption of vegetables, fruits or berries
|
daily
|
1
|
|
|
not every day
|
0
|
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the greater the risk for type 2 diabetes.
|
Total Score
|
Males
|
Females
|
|
0 to 3
|
< 1%
|
< 1%
|
|
4 to 8
|
1 - 2%
|
1%
|
|
9 to 12
|
3 - 11%
|
2 - 7%
|
|
13 to 20
|
23 - 33%
|
14 - 28%
|
rounded from the data in Table 2, page 727
Performance:
• The area under the ROC curve was 0.852.
• Using the cutoff of >= 9, the sensitivity was 0.78 for a 1987 cohort and 0.81 for the 1992 cohort.
• Using the cutoff of >= 9, the specificity was 0.77 for a 1987 cohort and 0.76 for the 1992 cohort.
