Risk scores for type 2 diabetes mellitus in Latin America: A systematic review of population-based studies

Abstract

Aims: Weaimed tosummarize the evidence ondiabetes risk scores forLatin American populations.Methods:A systematic review was conducted (CRD42019122306)looking for diagnostic and prognostic models for type 2 diabetes mellitusamong randomlyselected adults in Latin Americacountries. Five databases(LILACS, Scopus, Medline, Embase and Global Health) weresearched. Type 2 diabetes mellituswasdefined using at least one blood bio-markerandthe reports needed to include information on the development and/or validation of a multivariableregressionmodel. Risk of bias was assessed withthe PROBAST guidelines.Results:Out of the1,500 reports identified, 11 were studied in detailandfivewere included in the qualitative analysis. Two reports were from Mexico, two from Peru, and one from Brazil. The number of diabetes casesvaried from 48 to 207 in the derivations models, whereas these numbers ranged between 29 and582 in the validation models. The most common predictors were age, waist circumference and family history of diabetes, and only one study used oral glucose tolerance test as the outcome. The discrimination performance across studies was around 70% (range: 66% -72%) as per the area under the receiving-operator curve, thehighestmetric was always the negative prediction value. Sensitivity was always higher than specificity. Conclusion:There is no evidence to support the use of one risk scorethroughout Latin America. The development, validation and implementation of risk scores should be a research and public health priorityin Latin America to improve type 2 diabetes mellitusscreening and prevention.