Using Questionnaires to Predict Prediabetes and Diabetes Risk
Since prediabetes
often leads to type 2 diabetes, a screening test,
in the form of a questionnaire, is often used to
identify individuals who are at risk for
prediabetes and diabetes. Such a questionnaire,
endorsed by the CDC and the ADA (American
Diabetes Association), is used in the CDC National
Diabetes Prevention Program. The questionnaire
consists of five questions, some of which are
related to cardiovascular health (CVH). And a recent
study, examining the use of a questionnaire
similar to the CDC/ADA questionnaire, has shown
that there is a positive correlation between a
high score on a CVH-related questionnaire and the
development of prediabetes or diabetes.
An individual’s
risk of prediabetes or diabetes increases
with age, so a question requesting the
individual’s age is on the CDC/ADA
prediabetes-diabetes-risk questionnaire. Men have
a higher risk of prediabetes and diabetes than
women, so a gender-related question is on the
questionnaire.
The risk
of prediabetes and diabetes increases for
women who experienced gestational diabetes, so a
gestational-diabetes question is on the
questionnaire. Questions are also asked about
immediate family members who have had diabetes,
since an immediate-family-history of diabetes can
raise a person’s risks of diabetes and
prediabetes.
Questions about
weight and physical activity are also part
of the questionnaire, since excess body fat and a
lack of adequate physical activity can raise the
risk of prediabetes and diabetes. A question
concerning a diagnosis of high blood pressure is
also on the questionnaire, since people with
hypertension are at a
high risk of diabetes.
The CDC/ADA questionnaire is a good predictor of
prediabetes and diabetes risk. It is derived from
a questionnaire
the ADA published in 1995. And a recently
developed questionnaire, using slightly different
CVH metrics, also gives good indications of
prediabetes and diabetes risk.
The more recent questionnaire is based on a CVH-related
study investigating the use of a
questionnaire to identify individuals with a high
risk of acquiring prediabetes or diabetes. The
study consisted of 403,857 participants who were
18-71 years of age. The researchers looked at
fasting plasma glucose (FPG) data over a period of
five consecutive years. And the researchers
concluded that a group of CVH markers can be used
to predict prediabetes and diabetes. Researchers,
using the questionnaire, asks questions to
determine if a person smokes, engages in physical
activity, is overweight or obese, has untreated
total cholesterol, high blood pressure or eats
breakfast infrequently.
The researchers concluded that “The ideal
CVH metrics were as follows: BMI of
<25 kg/m2; non-smoking; 30 min of physical
activity ≥twice weekly or ≥1 h of walking per day;
... skipping breakfast <3 times per week;
systolic untreated blood pressure/diastolic blood
pressure of <120/80 mmHg; and total cholesterol
of <200 mg/dL”
Furthermore, the probability
of acquiring prediabetes or diabetes
increased as the number of non-ideal CVH metrics
increased over a period of one year. And the
association between a non-ideal BMI and the
likelihood of prediabetes or diabetes was the
strongest among the metrics.
Hence, healthcare providers should consider the
use of questionnaires to help identify clients or
patients who are at a high risk of prediabetes and
diabetes.
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