In Africa 70% of people living with diabetes (DM) are undiagnosed. To address this challenge, prediction equations must be tested in Africans. As the A1C-modified Atherosclerosis Risk in Communities (ARIC) DM prediction equation was optimized in African Americans, our goal was to test in Africans: 1) ability of the equation to detect undiagnosed DM; 2) contribution of each biochemical variable to the equation; 3) independent value of each biochemical variable. The equation has 5 clinical and 4 biochemical variables: HDL, TG, A1C and fasting plasma glucose (FPG). Participants were 421 African-born blacks living in the U.S. (66% male; age 38±10y (mean ±SD); BMI 27.5±4.4 kg/m2). OGTT was performed. DM diagnosis required 2h glucose ≥200 mg/dL. Area under the receiver operating characteristic curve (AROC) predicted DM. Youden Index estimated optimal cut points. DM occurred in 6% (27/421). AROC for the full equation was 0.84. Only with FPG excluded from the equation did the AROC decline (P<0.01) (Table 1A). Single predictor variables HDL, TG, A1C had low AROC. However, FPG as a single predictor had AROC 0.89 and was equivalent to the full equation (Table 1B). Thus, DM was identified by the full equation in 78% (21/27) and by FPG alone in 81% (22/27). Optimal cut point for FPG was 100 mg/dL. For the detection of DM, FPG ≥100 mg/dL performed as well as the A1C-modified ARIC equation.
M.F. Horlyck-Romanovsky: None. R. Mugeni: None. J.Y. Aduwo: None. S.M. Briker: None. C. DuBose: None. L. Mabundo: None. S.T. Chung: None. J. Ha: None. A. Sherman: None. A.E. Sumner: None.
National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Minority Health and Health Disparities