All ETDs from UAB

Advisory Committee Chair

Andrea L Cherrington

Advisory Committee Members

Jeffrey Gonzalez

Gregory Pavela

Dorothy Pekmezi

Document Type

Dissertation

Date of Award

2019

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Background: Diabetes prevalence is increasing worldwide affecting vulnerable popula-tions, in particular Hispanics living in the United States (U.S.). The burden of diabetes and its complications can be reduced by identifying those at high risk and routing them to treatment and intensive behavioral interventions. Aim: The aim of this study is to develop and validate a simple score to identify undiag-nosed diabetes among Hispanics living in the U.S. Methods: A representative sample of Hispanics living in the U.S. was used to develop and validate the score. Logistic regression was used to identify significant risk factors and model coefficients were used to assign points for the score. The risk score was validated using a split sample and comparing its performance to similar risk scores. Results: Being of Mexican descent, male gender, older age, lower education, being born in the U.S., family history of diabetes, being overweight or obese, having had gestational diabetes and not complying with physical activity recommendations were risk factors included in the score. The model had an area under the ROC curve (AUC) of 0.76 in the development sample and of 0.77 in the validation sample. Other scores had AUCs be-tween 0.69 and 0.75. The SOL risk score also performed well identifying prediabetes, with an AUC of 0.68. The risk score also demonstrated reasonable performance detecting dysglycemia, AUC of 77%, sensitivity of 74% and specificity of 70%. Conclusion: This study presents the first diabetes risk score derived for Hispanics living in the U.S. It provides a simple and inexpensive tool to identify individuals at high risk of diabetes and prediabetes. Further work is still needed to validate this score in other His-panic populations. Tools developed specifically for Hispanic populations may be more effective among Hispanics than those developed for the general population.

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