Screening and staging type 2 diabetes risk with a 1 h oral glucose tolerance test and the Finnish diabetes risk score

Aims We aimed to develop a multistage schema to stratify diabetes risk using continuous plasma glucose (PG) values (fasting and 1 h) in combination with clinical variables. Methods In 962 Brazilian adults, we initially estimated the probability of developing diabetes with the Finnish Diabetes Risk Score (FINDRISC). We then stratified participants with a FINDRISC score of 9 or higher into three progressive high-risk stages based on their probability of developing diabetes. We evaluated the schemás ability to predict the incidence of diabetes using robust Poisson regression with a time offset, employing bootstrap resampling for internal validation. Results Over 5.31 (0.44) years of follow-up, we observed a steep and graded increase in the risk of diabetes across stages. Initiating screening with FINDRISC reduced OGTT testing by 35.1%. The staging schema categorized 39.1% (36.1–42.2) of the sample in three high-risk stages, with relative risk for incident diabetes ranging from 2.7 (1.0–7.4) to 14.9 (7.3–30.3). Adding 2 h PG and HbA 1c to scores produced little change. Conclusions A staging schema based on scores derived from continuous FPG and 1 h PG values along with clinical variables, applied after a FINDRISC screening, offers a nuanced and practical approach to identifying individuals for diabetes prevention.