RESULTS OF A TWO-STEP SCREENING STRATEGY FOR PREDIABETES AND DIABETES USING THE ADA RISK SCORE IN A COMMUNITY POPULATION
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Abstract
Objective: To describe the results of a two-step screening strategy using the ADA Risk Score followed by fasting plasma glucose (FPG) and HbA1c testing for detecting dysglycemia in a community population.
Subjects and methods: A descriptive cross-sectional study was conducted from February to June 2026 among 363 adults aged 35 years or older residing in Van Xuan commune, Hung Yen province. All participants were assessed using the ADA Risk Score. Participants with a score ≥5 were classified as high risk; after eligibility assessment for the laboratory phase, eligible participants were referred for FPG and HbA1c testing. Glycemic status was classified using the ADA 2025 laboratory thresholds.
Results: Of 363 screened participants, 112 (30.9%) had an ADA Risk Score ≥5. Of the 112 high-risk participants, 15 were ineligible because of a history of diabetes or current corticosteroid use; 97 were eligible for laboratory testing and 61 completed both FPG and HbA1c tests, corresponding to a completion rate of 62.9%. Among those tested, 18 (29.5%) had normal glycemic results, 26 (42.6%) were classified as having prediabetes, and 17 (27.9%) had laboratory values within the diabetes range. Overall, dysglycemia was detected in 43/61 participants (70.5%), corresponding to 1.42 individuals tested to detect one case of dysglycemia. Agreement between FPG and HbA1c was moderate (κ=0.45; p<0.001). Among 26 individuals with FPG in the prediabetes range, 20 had normal HbA1c values.
Conclusion: The two-step screening strategy using the ADA Risk Score identified a subgroup with a high proportion of dysglycemia for further laboratory evaluation. Agreement between FPG and HbA1c was moderate, indicating that the two tests may identify different groups of individuals. Participants with laboratory values in the diabetes range require confirmatory evaluation according to appropriate diagnostic recommendations.
Keywords
ADA Risk Score, prediabetes, diabetes, fasting plasma glucose, HbA1c, community screening
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References
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