Browsing by Subject "type 2 diabetes"

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    Open Access
    Independent external validation and comparison of prevalent diabetes risk prediction models in a mixed-ancestry population of South Africa
    (BioMed Central Ltd, 2015) Masconi, Katya L; Matsha, Tandi; Erasmus, Rajiv; Kengne, Andre
    BACKGROUND: Guidelines increasingly encourage the use of multivariable risk models to predict the presence of prevalent undiagnosed type 2 diabetes mellitus worldwide. However, no single model can perform well in all settings and available models must be tested before implementation in new populations. We assessed and compared the performance of five prevalent diabetes risk models in mixed-ancestry South Africans. METHODS: Data from the Cape Town Bellville-South cohort were used for this study. Models were identified via recent systematic reviews. Discrimination was assessed and compared using C-statistic and non-parametric methods. Calibration was assessed via calibration plots, before and after recalibration through intercept adjustment. RESULTS: Seven hundred thirty-seven participants (27% male), mean age, 52.2years, were included, among whom 130 (17.6%) had prevalent undiagnosed diabetes. The highest c-statistic for the five prediction models was recorded with the Kuwaiti model [C-statistic 0.68: 95% confidence: 0.63-0.73] and the lowest with the Rotterdam model [0. 64 (0.59-0.69)]; with no significant statistical differences when the models were compared with each other (Cambridge, Omani and the simplified Finnish models). Calibration ranged from acceptable to good, however over- and underestimation was prevalent. The Rotterdam and the Finnish models showed significant improvement following intercept adjustment. CONCLUSIONS: The wide range of performances of different models in our sample highlights the challenges of selecting an appropriate model for prevalent diabetes risk prediction in different settings.
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    Open Access
    Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans
    (BioMed Central Ltd, 2012) Kengne, Andre; Limen, Serge; Sobngwi, Eugene; Djouogo, Catherine FT; Nouedoui, Christophe
    BACKGROUND: Available definition criteria for metabolic syndrome (MS) have similarities and inconsistencies. The aim of this study was to determine the prevalence of MS in a group of Cameroonians with type 2 diabetes, according to the International Diabetes Federation (IDF) and the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III) criteria, and to assess the concordance between both criteria, and the implications of combining them. METHODS: We collected clinical and biochemical data for 308 patients with type 2 diabetes (men 157) at the National Obesity Center of the Yaounde Central Hospital, Cameroon. Concordance was assessed with the use of the Kappa statistic. RESULTS: Mean age (standard deviation) was 55.8 (10.5) years and the median duration of diagnosed diabetes (25th-75th percentiles) was 3years (0.5-5.0), similarly among men and women. The prevalence of MS was 71.7% according to the IDF criteria and 60.4% according to NCEP-ATP III criteria. The prevalence was significantly higher in women than in men independently of the criteria used (both p<0.001). Overall concordance between both definitions was low to average 0.51 (95% confidence interval: 0.41-0.61). Combining the two sets of criteria marginally improved the yield beyond that provided by the IDF criteria alone in men, but not in the overall population and in women. CONCLUSIONS: The IDF and NCEP-ATP III criteria do not always diagnose the same group of diabetic individuals with MS and combining them merely increases the yield beyond that provided by the IDF definition alone. This study highlights the importance of having a single unifying definition for MS in our setting.