Development and validation of a risk assessment tool for uncontrolled type 2 diabetes among patients in South Karnataka, India.

Introduction: Diabetes is a chronic medical condition with severe complications mainly caused due to unhealthy lifestyles in genetically susceptible individuals. This study attempts to develop a non-invasive risk assessment tool to identify patients with uncontrolled type 2 diabetes mellitus (T2DM) in southern India. Methodology: An exploratory study was conducted among 545 patients with T2DM in the Mysuru district, South India for 6 months. A prevalidated questionnaire was used to collect data. Univariate and multivariate logistic regression analysis was performed to develop the risk score. Receiver-operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the cut-off for the risk score. The risk score is specifically designed for the population of South Karnataka, India. Results: Out of the 545 study participants, the prevalence of uncontrolled diabetes was 59.9%. Physical activity, duration of diabetes, diabetic diet, regular health check-ups, history of hypertension, smoking history and alcohol consumption were factors significantly associated with uncontrolled diabetes (p<0.05). For an optimum cut-off point of >13.50, the risk assessment model showed a moderate sensitivity of 71.3%, specificity of 61%, positive predictive value of 73.2% and negative predictive value of 58.3%. The ROC curve was plotted for the model with an AUC of 0.726 (95% CI 0.683 to 0.769). Conclusion: This study developed 'Diabetes Care', a simple web-based, non-invasive and inexpensive tool for identifying individuals at risk of developing uncontrolled T2DM in the future.