How to screen for diabetes risk in multi-ethnic populations: does one method fit all?

Abstract

The question as to how to screen diabetes risk in a multi-ethnic population is not easy to answer. There are a number of diagnostic procedures and risk score tools which may help identify people with increased risk. Some of the risk factors for diabetes have a clear ethnic component, thus the risk stratification is different in Caucasian, Asian and Latin American populations. However, we can expect that the pathophysiology for diabetes development consisting of insulin resistance and progressive beta-cell failure is very similar in its pathomechanistic background between ethnic groups, although the speed and progressive destruction may have ethnic and varying genetic components. In this environment, we have to find clinically applicable approaches to identify those with increased diabetes risk which have to be easy to understand, transparent and replicable for diabetes risk detection. The International Diabetes Federation recently started the PREDICT-2 study to develop a global diabetes risk score.

In this article, we discuss some of the strategies to identify diabetes risk and give some ideas about ethnic variation.

Keywords:

• risk score
• diabetes risk
• waist
• type 2 diabetes
• impaired glucose tolerence
• risk stratification