Development and Validation of an Undiagnosed Diabetes Screening Tool: Based on the Korean National Health and Nutrition Examination Survey (2010-2016)

Abstract

Approximately half of the population worldwide suffers from under/undiagnosed diabetes. In South Korea, 27.7% of people aged over 30 years have type 2 diabetes and are unaware of their condition because they have not been diagnosed. Optimal tools for identifying risk factors of undiagnosed diabetes, which is associated with multiple complications, are currently lacking. Secondary data analysis was conducted using the 2010-2016 Korean National Health and Nutrition Examination Survey. This study aimed to identify the risk factors in individuals not diagnosed with type 2 diabetes, using glycated hemoglobin as the diagnostic standard. Furthermore, we aimed to develop an accurate screening tool for diabetes using HbA1c values by analyzing the data of 12,843 adults (aged ≥20 years) not diagnosed with type 2 diabetes. Age, gender, family history of diabetes, hypertension diagnosis, waist-to-height ratio, smoking, and health check-ups were identified as significant risk factors for undiagnosed type 2 diabetes. A screening tool with total and cutoff scores of 13 and 7 points was developed, and it had a sensitivity of 82.7% and specificity of 58.2%. The developed screening tool appears to be a simple and cost-effective method for detecting undiagnosed type 2 diabetes.