PERFORMANCE OF AN NIDDM SCREENING QUESTIONNAIRE BASED ON SYMPTOMS ANDRISK-FACTORS

OBJECTIVE - To investigate to what extent a short questionnaire on sym ptoms and risk factors can be used to identify people at increased ris k for undiagnosed NIDDM. RESEARCH DESIGN AND METHODS - A general popul ation sample of 2,364 Caucasian subjects, age 50-74 years, not known t o have diabetes, completed a questionnaire on diabetes-related symptom s and risk factors. Subsequently, they underwent an oral glucose toler ance test. A backward stepwise multiple logistic regression was carrie d out with the absence or presence of newly detected diabetes as the d ependent variable and the items from the questionnaire as the independ ent variables. The selected items were included in a new symptom risk questionnaire, which was evaluated in a different population sample of 786 subjects, age 45-74 years, not known to have diabetes and compare d with existing questionnaires. RESULTS - The newly developed symptom- risk questionnaire contains questions concerning the following items, which were independently and significantly (P < 0.05) associated with the presence of previously undiagnosed diabetes: pain during walking w ith need to slow down, shortness of breath when walking with people of the same age, frequent thirst, ape, sex, obesity, parent or sibling w ith diabetes, use of antihypertensive drugs, and reluctance to use a b icycle for transportation. The 1993 American Diabetes Association ques tionnaire, the 1995 Herman et al. (17) questionnaire, and the newly de veloped symptom-risk questionnaire had sensitivities of 59, 72, and 72 %; specificities of 57, 55, and 56%; positive predictive values of 5.6 , 6.4, and 6.5%; and negative predictive values of 97, 98, and 98%, re spectively. CONCLUSIONS - The newly developed symptom-risk questionnai re has good performance characteristics, and the advantage of a variab le cutoff makes it a useful screening tool for NIDDM in general practi ce.