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Evaluation and refinement of the PRESTARt tool for identifying 12-14 year olds at high lifetime risk of developing type 2 diabetes compared to a clinicians assessment of risk: a cross-sectional study

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journal contribution
posted on 18.07.2019, 12:06 by L Gray, E Brady, O Albaina, C Edwardson, D Harrington, K Khunti, J Miksza, J Raposo, E Smith, A Vazeou, I Vergara, S Weihrauch-Blüher, M Davies
Background
Traditionally Type 2 Diabetes Mellitus (T2DM) was associated with older age, but is now being increasingly diagnosed in younger populations due to the increasing prevalence of obesity and inactivity. We aimed to evaluate whether a tool developed for community use to identify adolescents at high lifetime risk of developing T2DM agreed with a risk assessment conducted by a clinician using data collected from five European countries. We also assessed whether the tool could be simplified.

Methods
To evaluate the tool we collected data from 636 adolescents aged 12–14 years from five European countries. Each participant’s data were then assessed by two clinicians independently, who judged each participant to be at either low or high risk of developing T2DM in their lifetime. This was used as the gold standard to which the tool was evaluated and refined.

Results
The refined tool categorised adolescents at high risk if they were overweight/obese and had at least one other risk factor (High waist circumference, family history of diabetes, parental obesity, not breast fed, high sugar intake, high screen time, low physical activity and low fruit and vegetable intake). Of those found to be at high risk by the clinicians, 93% were also deemed high risk by the tool. The specificity shows that 67% of those deemed at low risk by the clinicians were also found to be a low risk by the tool.

Conclusions
We have evaluated a tool for identifying adolescents with risk factors associated with the development of T2DM in the future. Future work to externally validate the tool using prospective data including T2DM incidence is required.

Funding

The authors also acknowledge support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care — East Midlands (NIHR CLAHRC — EM) and the Leicester NIHR Biomedical Research Centre, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester.

History

Citation

BMC Endocrine Disorders, 19, 79 (2019). https://doi.org/10.1186/s12902-019-0410-3

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences

Version

VoR (Version of Record)

Published in

BMC Endocrine Disorders

Volume

19

Issue

79

Publisher

BMC (part of Springer Nature)

eissn

1472-6823

Acceptance date

16/07/2019

Copyright date

2019

Available date

25/07/2019

Language

en