Type 2 Diabetes Risk Calculator

How does this Type 2 diabetes risk calculator work?

This health tool determines risk of type 2 diabetes based on the subject age, gender, body mass index and some of the main risk factors for this condition such as family history, hypertension or smoking.

There are 6 items investigated in the type 2 diabetes risk calculator, most of them comprising of routinely collected data:

■ Gender – gender T2DM occurrence is related to the risk of heart disease, higher in adult men but of similar values after 65 years of age.

■ Prescription hypertensive – hypertensive patients, have a greater incidence of death and morbidity from diabetes related cardiovascular events (including myocardial infarction, stroke, angina). Patients with both hypertension and diabetes have approximately four times the cardiovascular risk of non-diabetic non-hypertensive subjects. Sustained blood pressure >135/80 mmHg is indication for screening.

■ Prescription steroids – Corticosteroid therapy aimed at reducing inflammation can lead to diabetes in people who are already at high risk of developing it. Long term corticosteroid therapy increases insulin resistance thus contributes to lasting hikes in blood glucose levels.

■ Age – increasing age is one of the main risk factors of T2DM. American Diabetes Association (ADA) recommends screening starting from 45 years.

■ Body mass index – is one of the strong independent risk factors associated with positive diagnosis with correlation degree increasing for higher BMI values.

■ Family history – refers to first degree relatives (siblings and parents) suffering diabetes.

■ Smoker – diabetes is another possibly occurring complication of smoking.

Depending of the selected answers, each of the items is awarded a value which is then input in the following formulas to reveal the overall percentage risk:

Terms = 6.322 - Sex - Rx Hypertensive - Rx Steroids - (0.063 x Age) - BMI - Family history - Smoker

Risk = 100 / (1 + e^(Terms))

The table below presents the values awarded for each possible answer:

Often, type 2 diabetes goes unrecognized for many years and diagnosis comes when tissues and cardiovascular damage have already been produced. This is one of the reasons evaluation of risk and early detection are essential.

In the test population, the score has proven 72% specificity, 77% sensitivity and a likelihood ratio of 2.76.

Diabetes mellitus symptoms and diagnosis

For a lot of people type 2 diabetes may be asymptomatic or present with mild symptoms, therefore may go unnoticed for months and years in a row.

Some of the diabetes symptoms are:

■ Being very thirsty (polydipsia);

■ Passing more urine (polyuria);

■ Tingling or numbness in hands or feet (paresthesias);

■ Unexplained weight loss;

■ Fatigue;

■ Irritability;

■ Blurry vision;

■ Poorly healing wounds;

■ Recurrent yeast infections;

■ Hyperglycemia.

Diagnosis includes blood testing for signs of diabetes, some test are done once while others may be repeated in different days to confirm diagnosis (for example maintained blood glucose):

■ HbA1C –  (glycated hemoglobin test) offers information on blood glucose values over the past 2, 3 months;

■ Fasting plasma glucose – measures blood sugar after eight hours of fast (not drinking or eating anything);

■ Oral glucose tolerance test (OGTT) – measures blood glucose before and two hours after a sugary drink.

Diagnosis criteria by the American Diabetes Association (ADA) includes:

■ FPG (fasting plasma glucose) ≥126 mg/dL (7.0 mmol/L) OR;

■ Two-hour plasma glucose level of 200 mg/dL (11.1 mmol/L) or higher during OGTT OR;

■ Random plasma glucose of 200 mg/dL (11.1 mmol/L) in patient with classic symptoms of hyperglycemia or hyperglycemic crisis.

References

1) Griffin SJ, Little PS, Hales CN, et al. (2000) Diabetes risk score: towards earlier detection of Type 2 diabetes in general practice. Diabet Metab Res Rev; 16: 164-71.

2) Simmons LR, Molyneaux L, Yue DK, Chua EL. (2012) Steroid-Induced Diabetes: Is It Just Unmasking of Type 2 Diabetes? ISRN Endocrinol; 2012: 910905.

3) Fletcher B1, Gulanick M, Lamendola C. (2002) Risk factors for type 2 diabetes mellitus. J Cardiovasc Nurs; 16(2):17-23.

4) Hypertension in Diabetes Study (HDS): II. Increased risk of cardiovascular complications in hypertensive type 2 diabetic patients. J Hypertens. 1993 Mar; 1(3):319-25.

5) Chang SA. (2012) Smoking and Type 2 Diabetes Mellitus. Diabetes Metab J; 36(6): 399–403.