Predictors of undiagnosed prevalent type 2 diabetes - The Danish General Suburban Population Study

Prim Care Diabetes. 2018 Feb;12(1):13-22. doi: 10.1016/j.pcd.2017.08.005. Epub 2017 Sep 28.


Aims: To investigate how self-reported risk factors (including socioeconomic status) predict undiagnosed, prevalent type 2 diabetes mellitus (T2DM). To externally validate Leicester Risk Assessment Score (LRAS), Finnish Diabetes Risk Score (FINDRISC) and Danish Diabetes Risk Score (DDRS), and to investigate how these predict a European Heart SCORE≥5% in a Danish population study.

Methods: We included 21,205 adults from the Danish General Suburban Population Study. We used relative importance calculations of self-reported variables in prediction of undiagnosed T2DM. We externally validated established prediction models reporting ROC-curves for undiagnosed T2DM, pre-diabetes and SCORE.

Results: More than 20% of people with T2DM were undiagnosed. The 7 most important self-rated predictors in sequential order were high BMI, antihypertensive-therapy, age, cardiovascular disease, waist-circumference, fitness compared to peers and family disposition for T2DM. The Area Under the Curve for prediction of undiagnosed T2DM was 77.1 for LRAS; 75.4 for DDRS and 67.9 for FINDRISC. AUCs for SCORE was 75.1 for LRAS; 62.3 for DDRS and 54.3 for FINDRISC.

Conclusions: BMI and self-reported cardiovascular disease are important risk factors for undiagnosed T2DM. LRAS performed better than DDRS and FINDRISC in prediction of undiagnosed T2DM and SCORE≥5%. SCORE performed best in predicting pre-diabetes.

Keywords: Fitness; Self assessment; Socioeconomic status; Undiagnosed diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Area Under Curve
  • Blood Pressure / drug effects
  • Body Mass Index
  • Comorbidity
  • Cross-Sectional Studies
  • Denmark / epidemiology
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Educational Status
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Physical Fitness
  • Prediabetic State / diagnosis
  • Prediabetic State / epidemiology*
  • Predictive Value of Tests
  • Prevalence
  • ROC Curve
  • Risk Assessment
  • Risk Factors
  • Self Report*
  • Social Class
  • Socioeconomic Factors*
  • Suburban Health*
  • Waist Circumference
  • Young Adult


  • Antihypertensive Agents