The Development and Testing of a 6-Items Pre-Diabetes Screening Tool

Monday, 30 July 2012

Tsai-Rung Lin, BS
Department of Nursing, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
Chiu-Chu Lin, PhD
School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan

Learning Objective 1: The learners will be able to learn the process of how to develop and test a screening tool that aims to identify people with pre-diabetes.

Learning Objective 2: The learners, in particular the community nurses can utilize the prediabetes screening tool(PST) to assess people at high risk of developing the diabetes.

Purpose: Diabetes prevention is a global health issues. To identify people at high risk of developing the diabetes, the healthcare professionals have to measure fasting glucose or two-hour oral glucose tolerance test (OGTT) that is inconvenient, invasive, and costly. Thus, we attempt to develop a simple prediabetes screening tool (PST) without the laboratory data.The purpose of this study is to develop and test a simple screening tool to identify people with pre-diabetes.

Methods: We conducted a consecutive community-based prediabetes survey. The subjects recruited from the community and department of physical examination of one medical center and one metropolitan hospital in southern Taiwan. The subjects (N=1112) completed the questionnaire and underwent a fasting glucose test after their regular physical examination. The area under the receiver operating characteristic curve (AUC) was used in this study to examine the sensitivity and specificity of PST .

Results:  Risk factors comprised in the PST include age, smoking status, waist circumference, systolic blood pressure, hypertension, and history of cardiovascular disease. Scores for the screening tool ranged between 4 and 14 points. The area under the AUC was 0.72 (95%CI:0.69, 0.76) for the cutoff point of 4, the sensitivity , specificity, positive predictive value, and negative predictive value of the screening tool was 76.89%, 54.76%, 38.23%, and 86.68%, respectively.

Conclusion: Empirical data supports the PST is a valid and feasible screening tool that could be widely used to early identify prediabetes people who may be asymptomatic in the community.