Sunday, July 28, 2024

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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