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(Article 33 | POJ_0027.html) Issue January 2017 - June 2017)

Winning Oral/Poster Presentation

PhilSPEN 2014 Convention

Submitted: October 8, 2014 | Posted: October 10, 2014

Third Prize: Validation of diabetes risk assessment form (DRAF, adapted from FINDRISC) among undiagnosed Diabetes Mellitus Type 2 adults in Barangay 212, Zone 19, District 11. Manila – a cross sectional analytical study

Title: Validation of diabetes risk assessment form (DRAF, adapted from FINDRISC) among undiagnosed Diabetes Mellitus Type 2 adults in Barangay 212, Zone 19, District 11. Manila – a cross sectional analytical study

Author(s): Cindy Chua, RND, MSCN and Jose Ma. Angbengco, MD, DPBCN

Institution where study was conducted: Philippine Women's University, Manila, Philippines

Background: Diabetes Mellitus (DM) is considered an emerging disease worldwide. The Western Pacific region has the largest number of DM-2 cases with 132 million where 76 million (57.9%) are undiagnosed. Being the 2nd  largest undiagnosed population following Africa, there are 1 in 3 adults with DM in this region. Since there is an increasing incidence of DM in the Philippines, the importance of early detection will prevent and delay onset of DM-2. Finding other assessment tools that is non-invasive could be helpful to increase awareness of undiagnosed population at risk for DM-2.

Objectives: This study was conducted to validate the usefulness of Diabetes Risk Assessment Form or DRAF (adapted from FINDRISC), using the following measures of accuracy: sensitivity, specificity, positive predictive value, and negative predictive value, for the identification of those with DM-2 among residents at Barangay 212 Zone 19, District II, in the City of Manila, from April 2014 – May 2014. The following were the major secondary objectives: to determine the demographic data of the undiagnosed residents; to determine the Total DM-2 Risk Score; and to determine the association between DM risk factors (age, BMI, waist circumference, daily physical activity, diet, presence of high blood pressure, history of DM, family history of DM) and the Total DM-2 Risk Score, with a cut-off point >9, versus OGTT.

Methods: The cross sectional analytical design was used, wherein 105, (70.48% female and 29.52% male), out of 121, finished the study. Purposive sampling was utilized with a sample size of 101 and 80% statistical power. Mean and standard deviation were used for numerical data, whereas, ratio and proportion were used for categorical data. Logistic Regression and Odds Ratio were computed to determine the risk total score versus OGTT, whereas, sensitivity, specificity, positive predictive value, and negative predictive value, and accuracy were used for measures of accuracy.

Results: The demographic profile were as follows: 16.19% young adult (19-39 years old), 51.43% middle age (40-59 years old), and 32.38% elderly group (>60 years old), with a mean age of 52.98. There was a waist-hip ratio of 31.43% normal cut off; while 68.57% above the cut off with a mean of 0.91. BMI reported were 60.95% (< 25kg/m2), 30.48% (25-30kg/m2), and 8.57% (>30kg/m2) with a mean of 24.02. Using OGTT, there were 74.29% without DM and with pre-diabetes, whereas, 25.71% had Type2DM. Based on the DRAF, the study showed that 86.67% participants had low to moderate DM risk; while 13.33% with DM high risk cut off (>15). Daily physical activity and diet showed no significant association with Total DM-2 risk score. There is a 3.2 times to 8 times chance that participants have DM-2 when classified, using a cut off score of >9. The following were the measures of accuracy: 74.07% Sensitivity; 52.56% Specificity; 85.42% Negative Predictive Value; 35.09% Positive Predictive Value; and 58.10% Accuracy (AUC: 0.63, 95% CI 0.53–0.73), that shows a moderate diagnostic accuracy. There was also a significant relationship between those with high risk scores and DM-2 status (OR 3.16, p=0.020 <0.05, 95% CI 1.20–8.34).

Conclusion: This study validates that Diabetes Risk Assessment Form (DRAF), adapted from FINDRISC, is a non-invasive screening tool that may be used as an adjunct to laboratory screening for DM-2.

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