A NEW AND SIMPLE QUESTIONNAIRE TO IDENTITY PEOPLE AT INCREASED RISK FOR UNDIAGNOSED DIABETES

OBJECTIVE - To develop a simple questionnaire to prospectively identif y individuals at increased risk for undiagnosed diabetes. RESEARCH DES IGN AND METHODS - People with newly diagnosed diabetes (n = 164) ident ified in the Second National Health and Nutrition Examination Survey a nd those with neither newly diagnosed diabetes nor a history of physic ian-diagnosed diabetes (n = 3,220) were studied. Major historical risk factors for undiagnosed non-insulin-dependent diabetes were defined, and classification trees were developed to identify people at higher r isk for previously undiagnosed diabetes. The sensitivity, specificity, and predictive value of the classification trees were described and c ompared with those of an existing questionnaire. RESULTS - The selecte d classification tree incorporated age, sex, history of delivery of a macrosomic infant, obesity, sedentary lifestyle, and family history of diabetes. In a representative sample of the U.S. population, the sens itivity of the tree was 79%, the specificity was 65%, and the predicti ve value positive was 10%. CONCLUSIONS - This classification tree perf ormed significantly better than an existing questionnaire and should s erve as a simple, noninvasive, and potentially cost-effective tool for diagnosing diabetes in the U.S.