Featherstone Travis, Eurich Dean T, Simpson Scot H
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada.
Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Value Health. 2017 Mar;20(3):329-335. doi: 10.1016/j.jval.2016.09.2403. Epub 2016 Nov 11.
Undiagnosed diabetes can create significant management issues for seniors.
To evaluate the effectiveness of two diabetes risk surveys-the Canadian Diabetes Risk Assessment Questionnaire (CANRISK) and the Finnish Diabetes Risk Score (FINDRISC)-to identify elevated blood glucose levels in seniors.
A cross-sectional study was conducted in senior living facilities in Edmonton, Alberta, Canada. Those with known diabetes, without capacity, considered frail, or unable to communicate in English were excluded. Participants completed the CANRISK and FINDRISC surveys and had their glycated hemoglobin A (HbA) measured. Correlations between seniors with elevated risk on the surveys and an HbA value of 6.5% or higher or 6.0% and higher were assessed.
In this study, 290 residents participated; their mean age was 84.3 ± 7.3 years, 82 (28%) were men, and their mean HbA level was 5.7% ± 0.4%. Mean CANRISK score was 29.4 ± 8.0, and of the 254 (88%) considered to be moderate or high risk, 10 (4%) had an HbA level of 6.5% or higher and 49 (19%) had an HbA level of 6.0% or higher. Mean FINDRISC score was 10.8 ± 4.2, and of the 58 (20%) considered to be high or very high risk, 4 (7%) had an HbA level of 6.5% or higher and 15 (26%) had an HbA level of 6.0% or higher. The area under the receiver-operating characteristic curve was 0.57 (95% confidence interval 0.42-0.72) for the CANRISK survey identifying participants with an HbA level of 6.5% or higher and 0.59 (95% confidence interval 0.51-0.67) for identifying participants with an HbA level of 6.0% or higher. Similar characteristics were observed for the FINDRISC survey.
In this group of seniors with no known diabetes history, mean HbA level approximated that in the general population and neither survey effectively identified those with elevated blood glucose levels. These findings should be confirmed in a larger study; nevertheless, routine use of these surveys as a diabetes screening strategy does not appear to be warranted at this time.
未确诊的糖尿病会给老年人带来重大的管理问题。
评估两种糖尿病风险调查——加拿大糖尿病风险评估问卷（CANRISK）和芬兰糖尿病风险评分（FINDRISC）——在识别老年人血糖水平升高方面的有效性。
在加拿大艾伯塔省埃德蒙顿的老年生活设施中进行了一项横断面研究。排除已知患有糖尿病、无行为能力、被认为身体虚弱或无法用英语交流的人。参与者完成了CANRISK和FINDRISC调查，并测量了糖化血红蛋白A（HbA）。评估了调查中风险升高的老年人与HbA值≥6.5%或≥6.0%之间的相关性。
本研究中，290名居民参与；他们的平均年龄为84.3±7.3岁，82名（28%）为男性，平均HbA水平为5.7%±0.4%。CANRISK平均得分为29.4±8.0，在被认为中度或高风险的254名（88%）参与者中，10名（4%）的HbA水平≥6.5%，49名（19%）的HbA水平≥6.0%。FINDRISC平均得分为10.8±4.2，在被认为高风险或非常高风险的58名（20%）参与者中，4名（7%）的HbA水平≥6.5%，15名（26%）的HbA水平≥6.0%。CANRISK调查识别HbA水平≥6.5%参与者的受试者工作特征曲线下面积为0.57（95%置信区间0.42 - 0.72），识别HbA水平≥6.0%参与者的为0.59（95%置信区间0.51 - 0.67）。FINDRISC调查也观察到类似特征。
在这组无已知糖尿病病史的老年人中，平均HbA水平接近一般人群，两种调查均未有效识别出血糖水平升高的人群。这些发现应在更大规模的研究中得到证实；然而，目前似乎没有必要将这些调查作为糖尿病筛查策略常规使用。
