A prospective comparison of the AUSDRISK and HbA1c for persons with spinal cord injury

Abstract

Objective The primary object of this study was to determine the validity of the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) for predicting the development of type 2 diabetes in persons with spinal cord injury (SCI). Design and setting The prospective comparative study (December 2013-March 2014) collected data on AUSDRISK and haemoglobin A1c (HbA1c) in participants’ homes. Participants Participation rate was 67% (n=79). Study criteria: over 18 years of age, a SCI for more than 12 months, living at home, wheelchair dependant and no diabetes diagnosis. Main outcome measures AUSDRISK sensitivity and specificity in predicting incident type 2 diabetes in persons with SCI. Results Of the 79 participants, 81% were male, mean age was 53 years (SD 14.14) with 23.2years (median 23; SD +/- 13.2yrs) since injury. There was a positive correlation between length of time since SCI and risk score (AUSDRISK) (r =. 242, p =. 032). Participants with high AUSDRISK scores had higher HbA1c% (5.38 versus 5.2, p =. 026) level. The high risk classification explained a moderate amount of HbA1c % (area under curve =. 651; 95% CI. 53 -. 77). The level of HbA1c which had the highest sensitivity (.59) and specificity (.73) for risk classification was 5.25%. Waist circumference and physical activity items require further powered studies to determine if appropriately weighted. Conclusion Comparing the AUSDRISK with HbA1c assays, the AUSDRISK can predict type 2 diabetes risk in a person with SCI, although further powered studies are needed to be undertaken, to refine the predictive capacity of the tool.