Validación de un instrumento para el tamizaje de casos de diabetes tipo 2 y la vigilancia de personas en riesgo en México

Abstract

Objective. To validate a method for screening cases of type 2 diabetes and monitoring at-risk people in a community in northern Mexico. Methods. The screening instrument for type 2 diabetes (ITD, for its Spanish acronym) was developed using a multiple logistic regression analysis that made it possible to determine the association between a new diagnosis of diabetes (a dependent variable) and 11 known risk factors. Internal validations were performed (through v-fold cross-validation), together with external validations (through the monitoring of a cohort of healthy individuals). In order to estimate the relative risk (RR) of developing type 2 diabetes, the total ITD score is calculated on the basis of an individual's risk factors and compared against a curve that shows the probability of that individual developing the disease. Results. Of the 525 people in the cohort, 438 (83.4%) were followed for an average of 7 years (4.5 to 10 years), for a total of 2 696 person-years; 62 (14.2%) people developed diabetes during the time they were followed. Individuals scoring 55 points based on their risk factors demonstrated a significantly higher risk of developing diabetes in 7 years (RR = 6.1; IC95%: 1.7 to 11.1); the risk was even higher for those with a score of 75 points (RR = 9.4; IC95%: 2.1 to 11.5). Conclusions. The ITD is easy to use and a valid screening alternative for type 2 diabetes. Its use will allow more individuals to benefit from disease prevention methods and early diagnosis without substantially increasing costs and with minimal use of laboratory resources.