Validation of a Type 2 Diabetes Screening Tool in Rural Honduras
- Evan C. Milton, M.P.H.1,
- William H. Herman, M.D., M.P.H.1,2,
- Allison E. Aiello, Ph.D.1,3,
- Kris R, Danielson, B.S.4,
- Milton O. Mendoza-Avelarez, M.D.5 and
- John D. Piette, Ph.D. (jpiette{at}umich.edu)2,6
- 1 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor MI
- 2 Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor MI
- 3 Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor MI
- 4 College of Osteopathic Medicine, Michigan State University, Lansing MI
- 5 Yojoa Medical Center, Santa Cruz de Yojoa, Cortés, Honduras
- 6 Ann Arbor VA Healthcare System, Ann Arbor, MI, USA
Abstract
Objective: To validate a low-cost tool for identifying diabetes patients in rural areas of Latin America.
Research Design and Methods: A regression equation incorporating post-prandial time and a random plasma glucose was used to screen 800 adults in Honduras. Patients with a probability of diabetes of 20% or greater were asked to return for a fasting plasma glucose (FPG). A random fifth of those with a screener-based probability of diabetes < 20% was 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 diabetes patients in poor clinics in Latin America.
Footnotes
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- Received June 3, 2009.
- Accepted November 5, 2009.
- Copyright © American Diabetes Association
