ArticleBMC endocrine disorders2024
HbA1c comparable to fasting glucose in the external validation of the African Diabetes Risk Score and other established risk prediction models in Black South Africans.
Article in BMC endocrine disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Evaluation of Diabetes Risk Models Applied to the Prediction of Incident Dysglycaemia in African and European Populations.Diabetes, obesity & metabolism · 2026Article
- Differences in red blood cell fatty acid profiles by type 2 diabetes status in early-stage chronic kidney disease.Scientific reports · 2026Article
- Diagnostic value of urinary albumin creatinine ratio in predicting vision-threatening diabetic retinopathy in patients with diabetes: a systematic review and Meta-analysis.International journal of ophthalmology · 2026Article
- Predictors of metabolic syndrome among teachers in under-resourced schools in South Africa: Baseline findings from the KaziHealth workplace health intervention.PLOS global public health · 2025Article
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6 authors.
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Abstract
backgroundThe use of non-invasive risk scores to detect undiagnosed type 2 diabetes (T2D) ensures the restriction of invasive and costly blood tests to those most likely to be diagnosed with the disease. This study assessed and compared the performance of the African Diabetes Risk Score (ADRS) with three other diabetes risk prediction models for identifying screen-detected diabetes based on fasting plasma glucose (FPG) or glycated haemoglobin (HBA1c).
methodsAge, sex, waist circumference, body mass index, blood pressure, history of diabetes and physical activity levels from the SA-NW-PURE study were used to externally validate the ADRS and other established risk prediction models. Discrimination was assessed and compared using C-statistics and nonparametric methods. Calibration was assessed using calibration plots, before and after recalibration.
resultsNine hundred and thirty-seven participants were included; 14% had prevalent undiagnosed T2D according to FPG and 26% according to HbA1c. Discrimination was acceptable and was mostly similar between models for both diagnostic measures. The C-statistics for diagnosis by FPG ranged from 0.69 for the Simplified FINDRISC model to 0.77 for the ADRS model and 0.77 for the Simplified FINDRISC model to 0.79 for the ADRS model for diagnosis by HbA1c. Calibration ranged from acceptable to good, though over- and underestimation were present. All models improved significantly following recalibration.
conclusionsThe models performed comparably, with the ADRS offering a non-invasive way to identify up to 79% of cases. Based on its ease of use and performance, the ADRS is recommended for screening for T2D in certain Black population groups in South Africa. HbA1c as a means of diagnosis also showed comparable performance with FPG. Therefore, further validation studies can potentially use HbA1c as the standard to compare to.
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