Validation of a Type 2 Diabetes Screening Tool in Rural Honduras
- Evan C. Milton, MPH1,
- William H. Herman, MD, MPH1,2,
- Allison E. Aiello, PHD1,3,
- Kris R. Danielson, BS4,
- Milton O. Mendoza-Avelarez, MD5 and
- John D. Piette, PHD2,6
- 1Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan;
- 2Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan;
- 3Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan;
- 4College of Osteopathic Medicine, Michigan State University, Lansing, Michigan;
- 5Yojoa Medical Center, Santa Cruz de Yojoa, Cortés, Honduras;
- 6Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan.
- Corresponding author: John D. Piette, jpiette{at}umich.edu.
Abstract
OBJECTIVE To validate a low-cost tool for identifying diabetic patients in rural areas of Latin America.
RESEARCH DESIGN AND METHODS A regression equation incorporating postprandial time and a random plasma glucose was used to screen 800 adults in Honduras. Patients with a probability of diabetes of ≥20% were asked to return for a fasting plasma glucose (FPG). A random fifth of those with a screener-based probability of diabetes <20% were also asked to return for follow-up. The gold standard was an FPG ≥126 mg/dl.
RESULTS The screener had very good test characteristics (area under the receiver operating characteristic curve = 0.89). Using the screening criterion of ≥0.42, the equation had a sensitivity of 74.1% and specificity of 97.2%.
CONCLUSIONS This screener is a valid measure of diabetes risk in Honduras and could be used to identify diabetic patients in poor clinics in Latin America.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received June 3, 2009.
- Accepted November 5, 2009.
- © 2010 by the American Diabetes Association.
