Risk assessment of type 2 diabetes and validation of a non-invasive risk-prediction tool among women in an urban community in Delta State, Nigeria

Abstract

Background: Early identification of high-risk individuals is essential in the prevention and control of type 2 Diabetes Mellitus (T2DM). This study assessed the risk of T2DM and validated the American Diabetes Association (ADA) risk tool among urban Nigerian women.

Methods: This was a cross-sectional study of 159 consenting women aged ≥18 years, consecutively recruited at a medical outreach in Sapele, Delta State, Nigeria. The risk of T2DM was assessed with a modified ADA risk tool. Respondents’ weight, height, blood pressure and blood glucose levels were measured. Data were analyzed using SPSS version 23.0.

Results: The participants had a mean age of: 41.5(±13.2) years, body mass index: 27.3(±5.38) kg/m2, SBP: 128(±19.4) mmHg and DBP: 81(±10.8) mmHg. Five (3.1%) reported a history of gestational diabetes, 21 (13.2%) had a first degree relative with T2DM, 26 (16.4%) were physically inactive, and 37 (23.3%) reported a history of hypertension/use of anti-hypertensives. Forty-eight (30.2%) had a high-risk for prediabetes and undiagnosed DM. The ADA risk tool was found to be useful with sensitivity (81.8%), specificity (73.6%), and ROC area under the curve (0.848, 95%CI: 0.743–0.953). Respondents with a high-risk of prediabetes and undiagnosed DM had significantly higher mean BMI (30.7 vs 25.9kg/m2), SBP (141.9 vs 122.5mmHg) and DBP (85.9 vs 79.1 mmHg).

Conclusion: The performance of the ADA Risk Tool was useful in this study. One-in-three respondents had a high-risk of prediabetes and  undiagnosed DM. Overweight/obesity, older age, gestational diabetes and hypertension were significantly associated with a high-risk for  prediabetes and undiagnosed DM among women.

Keywords: American Diabetic Association Risk Tool; Prediabetes; Undiagnosed diabetes; Women, Nigeria.