FINDRISC modified for cuba as a tool for the detection of prediabetes and undiagnosed diabetes in Cuban population

Authors

DOI:

https://doi.org/10.17843/rpmesp.2024.414.14138

Keywords:

FINDRISC, LA-FINDRISC, Prediction, Screening, Type 2 Diabetes Mellitus, Prediabetes, Dysglycaemia

Abstract

Objectives. To evaluate the Finnish Diabetes Risk Score (FINDRISC) modified for Cuba as a tool for the detection of prediabetes and undiagnosed diabetes in Cuban  population. Materials and methods. An analytical cross-sectional and secondary source epidemiological study was conducted in 3737 adults aged 19 years and older with at least one risk factor for diabetes, they did not have previous diagnosis of prediabetes and diabetes mellitus and underwent oral glucose tolerance test for the diagnosis of dysglycemia. We applied the FINDRISC and the FINDRISC modified for Latin America (LA-FINDRISC) and Cuba (CUBDRISC), each with their own anthropometric parameters. The ROC curve was used to establish the cut-off point of each scale for the diagnosis of dysglycemia. Sensitivity, specificity, predictive values and likelihood ratios were calculated. The concordance between scales was calculated with Cohen's Kappa coefficient. Results. We found that 34.5% (n=1289) of the subjects were diagnosed with dysglycemia (28.1% had prediabetes and 6.4% had type 2 diabetes without previous diagnosis). The LA-FINDRISC and CUBDRISC scales showed an almost perfect concordance with the FINDRISC scale for the different cut-off values from 11 to 16 (0.882-0.890 and 0.910-0.922, respectively). The optimal cutoff point for detecting persons with dysglycemia was ≥ 13 for the FINDRISC and CUBDRISC scales (sensitivity was 63.6% and 61.6%; specificity was 84.3% and 86.0%, respectively) and ≥11 for LA-FINDRISC (sensitivity 58.0% and specificity 88.0%). Conclusions. We found almost perfect concordance between the diabetes risk scales. The FINDRISC score modified for Cuba proved to be a useful tool to identify persons with prediabetes and diabetes with a cut-off point of 13 in a Cuban population.

Downloads

Download data is not yet available.

References

Díaz Díaz O, Orlandi González N. Manual para el diagnóstico y tratamiento del paciente diabético a nivel primario de salud. Libros de autores cubanos. Cuba: Editorial Ciencias Médicas; 2016 [citado el 16 de junio de 2024]. Disponible en: http://www.ecimed.sld.cu/2016/11/17/manual-para-el-diagnostico-y-tratamiento-del-paciente-diabetico-a-nivel-primario-de-salud/.

Guías ALAD sobre el diagnóstico y tratamiento de la diabetes mellitus tipo 2 con medicina basada en la evidencia. México: Edición Parmanyer; 2019. [citado el 16 de junio de 2024] Disponible en: https://www.revistaalad.com/guias/5600AX191_guias_alad_2019.pdf.

International Diabetes Federation Atlas. 9na edition: 2019. [citado 25 de junio 2024] Disponible en: https://diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdf.

Ministerio de Salud Pública. Anuario Estadístico de Salud. 2021. Internet 2022. [Citado 09 de febrero 2023] Disponible en: https://files.sld.cu/dne/files/2022/10/Anuario-Estadistico-de-Salud-2021.-Ed-2022.pdf.

Diabetes Federation Atlas. 10th edition: 2021. Pág. 1-136. Internet 2022 [Citado 10 de feb 2023] Disponible en: https://diabetesatlas.org/atlas/tenth-edition/.

Bonet Gorbea M, Varona Pérez P, Chang La Rosa M, García Roche RG, Suárez Medina R, Arcia Montes de Oca N, et al. III Encuesta de factores de riesgo y actividades preventivas de enfermedades no transmisibles. Cuba 2010-2011. [Internet]. La Habana: Editorial Ciencias Médicas; 2015 [citado el 25 de junio de 2024]. Disponible en: https://extranet.who.int/ncdccs/Data/CUB_C5_Encuesta_nacional_FR_2010-11.pdf.

American Diabetes Association Professional Practice Committee; 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024. Diabetes Care 2024; 47 (Supplement_1): S20–S42. Disponible en: https://doi.org/10.2337/dc24-S002.

Palladino R, Tabak AG, Khunti K, Valabhji J, Majeed A, Millett C, et al. Association between pre-diabetes and microvascular and macrovascular disease in newly diagnosed type 2 diabetes. BMJ Open Diab Res Care 2020;8:e001061. doi: 10.1136/bmjdrc-2019-001061.

Gillies CL, Lambert PC, Abrams KR, Sutton AJ, Cooper NJ, Hsu RT, et al. Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis. BMJ. 2008;336(7654):1180-5. doi: 10.1136/bmj.39545.585289.25.

Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003;26(3):725-31. doi: 10.2337/diacare.26.3.725.

Gabriel R, Acosta T, Florez K, Anillo L, Navarro E, Boukichou N, Acosta-Reyes J, Barengo NC, Lindström J, Tuomilehto JO, Aschner P. Validation of the Finnish Type 2 Diabetes Risk Score (FINDRISC) with the OGTT in Health Care Practices in Europe. Diabetes Res Clin Pract. 2021;178:108976. doi: 10.1016/j.diabres.2021.108976.

Peralta Horacio M., Costa Gil José E., Saleme Antonio E. Evaluación del puntaje FINDRISC para detección de prediabetes y diabetes tipo 2 sin diagnóstico. Medicina (B. Aires) [Internet]. 2024 [citado el 11 de junio de 2024];84(1):1-10. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76802024000100001&lng=es.

Nieto-Martínez R, González-Rivas JP, Aschner P, Barengo NC, Mechanick JI. Transculturalizing Diabetes Prevention in Latin America. Ann Glob Health. 2017;83(3-4):432-43. doi: 10.1016/j.aogh.2017.07.001.

Bergmann A, Li J, Wang L, Schulze J, Bornstein SR, Schwarz PE. A simplified Finnish diabetes risk score to predict type 2 diabetes risk and disease evolution in a German population. Horm Metab Res. 2007;39(9):677-82. doi: 10.1055/s-2007-985353.

Makrilakis K, Liatis S, Grammatikou S, Perrea D, Stathi C, Tsiligros P, et al. Validation of the Finnish diabetes risk score (FINDRISC) questionnaire for screening for undiagnosed type 2 diabetes, dysglycaemia and the metabolic syndrome in Greece. Diabetes Metab. 2011;37(2):144-51.

doi: 10.1016/j.diabet.2010.09.006.

Soriguer F, Valdés S, Tapia MJ, Esteva I, Ruiz de Adana MS, Almaraz MC, et al. Validación del FINDRISC (FINnish Diabetes Risk SCore) para la predicción del riesgo de diabetes tipo 2 en una población del sur de España. Estudio Pizarra. Med Clin (Barc). 2012;138(9):371-6. doi:

1016/j.medcli.2011.05.025.

Hellgren MI, Petzold M, Björkelund C, Wedel H, Jansson PA, Lindblad U. Feasibility of the FINDRISC questionnaire to identify individuals with impaired glucose tolerance in Swedish primary care. A cross-sectional population-based study. Diabet Med. 2012;29(12):1501-5. doi:

1111/j.1464-5491.2012.03664.x.

Winkler G, Hídvégi T, Vándorfi G, Balogh S, Jermendy G. Prevalence of undiagnosed abnormal glucose tolerance in adult patients cared for by general practitioners in Hungary. Results of a risk-stratified screening based on FINDRISC questionnaire. Med Sci Monit. 2013;19:67-72. doi:

12659/msm.883747.

Schwarz PE, Li J, Lindstrom J, Tuomilehto J. Tools for predicting the risk of type 2 diabetes in daily practice. Horm Metab Res. 2009;41(2):86-97. doi: 10.1055/s-0028-1087203.

Salinero-Fort MA, Burgos-Lunar C, Lahoz C, Mostaza JM, Abánades-Herranz JC, Laguna-Cuesta F, et al. Performance of the Finnish Diabetes Risk Score and a Simplified Finnish Diabetes Risk Score in a Community-Based, Cross-Sectional Programme for Screening of Undiagnosed Type 2 Diabetes

Mellitus and Dysglycaemia in Madrid, Spain: The SPREDIA-2 Study. PLoS ONE 2016;11(7): e0158489. doi: 10.1371/journal.pone.0158489.

Jølle A, Midthjell K, Holmen J, Carlsen SM, Tuomilehto J, Bjørngaard JH, Åsvold BO. Validity of the FINDRISC as a prediction tool for diabetes in a contemporary Norwegian population: a 10-

year follow-up of the HUNT study. BMJ Open Diabetes Res Care. 2019;7(1):e000769. doi: 10.1136/bmjdrc-2019-000769.

Comentarios a la guía ESC 2019 sobre diabetes, prediabetes y enfermedad cardiovascular. Rev. Esp Cardiol 2020;73(5): doi: 10.1016/j.recesp.2019.11.024.

Vizzuett Montoya AR, López-García MDC. Uso del test FINDRISC para el tamizaje de Diabetes Mellitus tipo 2 en salud ocupacional. Revista Colombiana de Salud Ocupacional [Internet] 2021 (citado el 25 de junio de 2024);10(1),e-6419. Disponible en: https://doi.org/10.18041/2322-634X/

rcso.1.2020.6419.

Gomez-Arbelaez D, Alvarado-Jurado L, Ayala-Castillo M, Forero-Naranjo L, Camacho PA, Lopez-Jaramillo P. Evaluation of the Finnish Diabetes Risk Score to predict type 2 diabetes mellitus in a Colombian population: A longitudinal observational study. World J Diabetes. 2015;6(17):1337-44.

doi: 10.4239/wjd.v6.i17.1337.

Cantillo H, Ocampo D, Cuello K. Uso del instrumento FINDRISK para identificar el riesgo de prediabetes y diabetes mellitus tipo 2. Repert Med Cir. 2019;28(3):157-63. DOI: 10.31260/RepertMedCir.v28.n3.2019.956.

Carrillo-Larco RM, Aparcana-Granda DJ, Mejia JR, Bernabé-Ortiz A. FINDRISC in Latin America: a systematic review of diagnosis and prognosis models. BMJ Open Diabetes Res Care. 2020;8(1):e001169. doi: 10.1136/bmjdrc-2019-001169.

Bernabe-Ortiz A, Perel P, Miranda JJ, Smeeth L. Diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM in Peruvian population. Prim Care Diabetes. 2018;12(6):517-25. doi: 10.1016/j.pcd.2018.07.015.

Nieto-Martínez R, González-Rivas JP, Ugel E, Marulanda MI, Durán M, Mechanick JI, et al. External validation of the Finnish diabetes risk score in Venezuela using a national sample: The EVESCAM. Prim Care Diabetes. 2019;13(6):574-582. doi: 10.1016/j.pcd.2019.04.006.

Muñoz-González MC, Lima-Martínez MM, Nava A, Trerotola G, Paoli M, Cabrera-Rego JO, et al. FINDRISC Modified for Latin America as a Screening Tool for Persons with Impaired Glucose Metabolism in Ciudad Bolívar, Venezuela. Med Princ Pract. 2019;28(4):324-32. doi: 10.1159/000499468.

García-Alcalá H, Genestier-Tamborero CN, Hirales-Tamez O, Salinas-Palma J, Soto-Vega E. Frequency of diabetes, impaired fasting glucose, and glucose intolerance in high-risk groups identified by a FINDRISC survey in Puebla City, Mexico. Diabetes Metab Syndr Obes. 2012;5:403-6. doi: 10.2147/DMSO.S35545.

Mendiola-Pastrana IR, Urbina-Aranda II, Muñoz-Simón AE, Juanico-Morales G, López-Ortiz G. Evaluación del desempeño del Finnish Diabetes Risk Score (FINDRISC) como prueba de tamizaje para diabetes mellitus tipo 2. Aten Fam. 2018;25(1):22-26. https://doi.org/10.22201/facmed.14058871p.2018.1.62925.

Tankova T, Chakarova N, Atanassova I, Dakovska L. Evaluation of the Finnish Diabetes Risk Score as a screening tool for impaired fasting glucose, impaired glucose tolerance and undetected diabetes. Diabetes Res Clin Pract. 2011;92(1):46-52. doi: 10.1016/j.diabres.2010.12.020.

Vicente-Sánchez B, Vicente-Peña E, Altuna-Delgado A, Costa-Cruz M. Identificación de individuos con riesgo de desarrollar diabetes tipo 2. Revista Finlay [Internet]. 2015 [citado 2024 Jun 25]; 5(3): Disponible en: https://revfinlay.sld.cu/index.php/finlay/article/view/274.

Naranjo AA, Rodríguez ÁY, Llera RE, Aroche R. Diabetes risk in a Cuban primary care setting in persons with no known glucose abnormalities. MEDICC Rev. 2013;15(2):16-9. doi: 10.37757/MR2013V15.N2.4.

Díaz-Díaz O, Hernández-Rodríguez J, Domínguez-Alonso E, Martínez-Montenegro I, Bosch-Pérez Y, del-Busto-Mesa A, et al. Valor de corte de la circunferencia de la cintura como predictor de disglucemia. Revista Cubana de Endocrinologia [Internet]. 2017 [citado 25 Jun 2024]; 28 (1)

Disponible en: https://revendocrinologia.sld.cu/index.php/endocrinologia/article/view/57.

Díaz Díaz O, Cabrera Rode E, Orlandi González N, Araña Rosaínz MJ, Díaz Horta O. Aspectos epidemiológicos de la prediabetes, diagnóstico y clasificación. Rev Cubana Endocrinol [Internet]. 2011 [citado el 12 de junio de 2024]; 22(1): 3-10. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532011000100003&lng=es.

Šimundić AM. Measures of Diagnostic Accuracy: Basic Definitions. EJIFCC. 2009;19(4):203-11. PMID: 27683318; PMCID: PMC4975285.

Hassanzad M, Hajian-Tilaki K. Methods of determining optimal cutpoint of diagnostic biomarkers with application of clinical data in ROC analysis: an update review. BMC Med Res Methodol. 2024;24(1):84. doi: 10.1186/s12874-024-02198-2.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics [Internet]. 1977;33(1):159-74. Available from: http://dx.doi.org/10.2307/2529310.

Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677-86. doi: 10.1016/S0140-6736(09)61457-4.

Roberts S, Barry E, Craig D, et al. Preventing type 2 diabetes: systematic review of studies of cost effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes. BMJ Open 2017;7:e017184. doi: 10.1136/bmjopen-2017-017184.

Yamaoka K, Nemoto A, Tango T. Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis. Nutrients. 2019;11(6):1373. doi: 10.3390/nu11061373.

Jagannathan R, Neves JS, Dorcely B, Chung ST, Tamura K, Rhee M, Bergman M. The Oral Glucose Tolerance Test: 100 Years Later. Diabetes Metab Syndr Obes. 2020;13:3787-3805. doi: 10.2147/DMSO.S246062.

González Pedraza Avilés A, Ponce Rosas ER, Toro Bellot F, Acevedo Giles O, Dávila Mendoza R. Cuestionario FINDRISC FINnish Diabetes Risk Score para la detección de diabetes no diagnosticada y prediabetes. Arch Med Fam. [Internet]. 2018 [citado el 25 de junio de 2024];20(1):5-13.

Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=76223.

Villena L. Test de FINDRISC para determinar riesgo de diabetes mellitus aplicado a una población hospitalaria. PE: Universidad Peruana Cayetano Heredia [Internet]. 2021 [citado el 25 de junio de 2024]; Disponible en: https://hdl.handle.net/20.500.12866/9986.

Ayensa-Vazquez JA, Leiva A, Tauler P, López-González AA, Aguiló A, Tomás-Salvá M, Bennasar-Veny M. Agreement between Type 2 Diabetes Risk Scales in a Caucasian Population: A Systematic Review and Report. J Clin Med. 2020;9(5):1546. doi: 10.3390/jcm9051546.

Rokhman MR, Arifin B, Zulkarnain Z, Satibi S, Perwitasari DA, Boersma C, et al. Translation and performance of the Finnish Diabetes Risk Score for detecting undiagnosed diabetes and dysglycaemia in the Indonesian population. PLoS ONE 2022;17(7): e0269853. Disponible en: https://doi.org/10.1371/journal.pone.0269853.

Nieto-Martinez R, Barengo NC, Restrepo M, Grinspan A, Assefi A, Mechanick JI. Large scale application of the Finnish diabetes risk score in Latin American and Caribbean populations: a descriptive study. Front. Endocrinol. 2023;14:1188784. doi: 10.3389/fendo.2023.1188784.

Meijnikman AS, De Block CEM, Verrijken A, Mertens I, Van Gaal LF. Predicting type 2 diabetes mellitus: a comparison between the FINDRISC score and the metabolic syndrome. Diabetol Metab Syndr. 2018;10:12. doi: 10.1186/s13098-018-0310-0.

Downloads

Published

2024-12-03

Issue

Section

Original Article

How to Cite

1.
Cabrera-Rode E, Díaz-Díaz O, Orlandi González N, Ronald M. FINDRISC modified for cuba as a tool for the detection of prediabetes and undiagnosed diabetes in Cuban population. Rev Peru Med Exp Salud Publica [Internet]. 2024 Dec. 3 [cited 2024 Dec. 15];41(4):351-64. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/14138

Most read articles by the same author(s)