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The Finnish Diabetes Risk Score Is Associated with Insulin Resistance and Progression towards Type 2 Diabetes

Department of Medicine III (P.E.H.S., J.L., M.R., A.B., S.R.B., J.S.), Medical Faculty Carl Gustav Carus of the Technical University Dresden, 01307 Dresden, Germany; School for Physiology, Nutrition and Consumer Sciences (A.E.S.) of North-West University (Potchefstroom Campus), 2520 Potchefstroom, South Africa; Centre for Clinical Studies (M.H.), GWT-TUD GmbH, 01187 Dresden, Germany; Department of Public Health (J.T., J.L.), University of Helsinki, 00300 Helsinki, Finland; Diabetes Unit (J.L.), Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, 00300 Helsinki, Finland; and South Ostrobothnia Central Hospital (J.T.), 60200 Seinäjoki, Finland

Address all correspondence and requests for reprints to: Peter E. H. Schwarz, Medical Faculty Carl-Gustav-Carus of the Technical University Dresden, Medical Clinic III, Building 10, Room 108, Fetscherstrasse 74, 01309 Dresden, Germany. E-mail: peter.schwarz{at}uniklinikum-dresden.de.

Objective: The Finnish Diabetes Risk Score (FINDRISC) questionnaire is a practical screening tool to estimate the diabetes risk and the probability of asymptomatic type 2 diabetes. In this study we evaluated the usefulness of the FINDRISC to predict insulin resistance in a population at increased diabetes risk.

Design: Data of 771 and 526 participants in a cross-sectional survey (1996) and a cohort study (1997–2000), respectively, were used for the analysis. Data on the FINDRISC and oral glucose tolerance test parameters were available from each participant. The predictive value of the FINDRISC was cross-sectionally evaluated using the area under the curve-receiver operating characteristics method and by correlation analyses. A validation of the cross-sectional results was performed on the prospective data from the cohort study.

Results: The FINDRISC was significantly correlated with markers of insulin resistance. The receiver operating characteristics-area under the curve for the prediction of a homeostasis model assessment insulin resistance index of more than five was 0.78 in the cross-sectional survey and 0.74 at baseline of the cohort study. Moreover, the FINDRISC at baseline was significantly associated with disease evolution (P < 0.01), which was defined as the change of glucose tolerance during the 3 yr follow-up.

Conclusions: The results indicate that the FINDRISC can be applied to detect insulin resistance in a population at high risk for type 2 diabetes and predict future impairment of glucose tolerance.