Diabetes Risk Screening Tools for Prediabetes: A Comprehensive Scoping Review of Evidence and Implementation

BACKGROUND/OBJECTIVES: Diabetes risk screening tools are essential for identifying individuals with prediabetes and preventing the progression to diabetes. However, systematic reviews focusing on such tools, particularly for prediabetes screening, are scarce. This scoping review examines the characteristics, development methods, and effectiveness of diabetes risk assessment tools in identifying prediabetes and predicting its progression to diabetes.

MATERIALS AND METHODS: A scoping review was conducted following the Joanna Briggs Institute methodology. Searches were performed in PubMed, ScienceDirect, and Google Scholar, complemented by citation tracking. Eligible studies included asymptomatic adults with prediabetes. Studies were excluded if they lacked relevant data, were not in English, or had no validation measures. Data were extracted independently by two reviewers and synthesized narratively, focusing on study design, risk model features, performance statistics, and quality assessments.

RESULTS: Fourteen studies met the inclusion criteria, covering 26 risk models. Sensitivity and specificity were used in 9 risk screening tools, with Hazard Ratios and C-Statistics assessing diabetes progression in six. Common risk factors included age, BMI, family history of diabetes, and hypertension. Non-invasive tools and predictive models showed promise, with most studies assessed as having a low risk of bias using QUADAS-2. High-sensitivity tools utilizing FBG, HbA1c, and OGTT cutoffs demonstrated effectiveness but require balancing cost and feasibility for broader implementation.

CONCLUSION: A range of different screening tools has been tested that could identify people with prediabetes or a high risk of developing type 2 diabetes. However, where sufficient evidence was available to compare tools across studies the performance of these tools was inconsistent. Several tools have only been investigated in single studies, with uncertainty around their wider generalisability. Clinicians or researchers wishing to screen people for prediabetes or a high risk of developing type 2 diabetes using any of these tools should be aware of their potential limitations.

The full text of the article is available in the electronic version of the journal on the website www.dia-endojournals.ru

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