Validation of Finnish Diabetes Risk Score Indonesia Version in Yogyakarta
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Submitted
5 August 2020
5 August 2020
Published
28 February 2021
28 February 2021
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Abstract
Diabetes mellitus (DM) has developed as a major public health problem in the world. It is estimated that around 50% of diabetics have not been diagnosed in Indonesia, and only two-thirds of those diagnosed are undergoing treatment. This condition must be prevented. The purpose of this study was to determine the validity and reliability of the Indonesian version of the Finnish Diabetes Risk Score (FINDRISC) as an instrument for predicting type 2 diabetes mellitus (T2DM). This study was an observational study with a cross-sectional design on 60 research subjects who were indigenous people of Yogyakarta who live in Yogyakarta, which can be proven by Identity Cards by the inclusion and exclusion criteria. Validity was tested by the validity of criteria by type while using the area under the receiver-operating curve (ROC-AUC). In contrast, reliability was tested by internal consistency using Cronbach's alpha. The results showed that as many as 14 people or 23.33% experienced uncontrolled fasting blood sugar and 15 people had a risk score of FINDRISC more than 10. Based on the ROC AUC analysis, the value of 0.935 (95% CI 0.865 1.00) with a cut-off point of 10 with the value of Sn = 85%, Sp = 95%, PPV = 85%, NPV = 95%, +LR = 5.66, and -LR = 0.15. Based on the reliability test, the Cronbach's alpha value of 0.727 was obtained. The FINDRISC questionnaire is categorized as valid and reliable so that it can be a screening tool for understanding.
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References
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20. Steele CJ, Schöttker B, Marshall AH, Kouvonen A, O'Doherty MG, Mons U, et al. Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study: a population-based cohort study. BMJ Open. 2017;7(4):e013569. doi:10.1136/bmjopen-2016-013569
21. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes. 2014;7:587-91. doi:10.2147/dmso.s67400
22. Triwinarto A, Muljati S, Jahari AB. Cut-Off Point Indeks Massa Tubuh (Imt) Dan Lingkar Perut Sebagai Indikator Risiko Diabetes Dan Hipertensi Pada Orang Dewasa Di Indonesia. Penelitian Gizi Makanan J Nutr Food Res. 2012;35(2):119-35.
23. Septyaningrum N, Santi M. Lingkar Perut Mempunyai Hubungan Paling Kuat Dengan Kadar Gula Darah. Jurnal Berkala Epidemiologi. 2014;2(1):48-58. doi:10.20473/jbe.V2I12014.48-58
24. Nurayati L, Adriani M. Hubungan Aktifitas Fisik Dengan Kadar Gula Darah Puasa Penderita Diabetes Melitus Tipe 2. Amerta Nutr. 2017;1(2):80-7. doi:10.20473/amnt.v1i2.2017.80-87
25. Li M, Fan Y, Zhang X, Hou W, Tang Z. Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies. BMJ Open. 2014;4(11):e005497. doi:10.1136/bmjopen-2014-005497
26. Bazzano LA, Serdula MK, Liu S. Dietary intake of fruits and vegetables and risk of cardiovascular disease. Curr Atheroscler Rep. 2003;5(6):492-9. doi:10.1007/s11883-003-0040-z
27. Taylor EN, Hu FB, Curhan GC. Antihypertensive Medications and the Risk of Incident Type 2 Diabetes. Diabetes Care. 2006;29(5):1065-70. doi:10.2337/dc05-2366
28. Weycker D, Edelsberg J, Vincze G, Kjeldsen SE, Jamerson K, Khan ZM, et al. Risk of diabetes in a real-world setting among patients initiating antihypertensive therapy with valsartan or amlodipine. J Hum Hypertens. 2007;21(5):374-80. doi:10.1038/sj.jhh.1002159
29. Gayatri RW. Hubungan Faktor Riwayat Diabetes Mellitus Dan Kadar Gula Darah Puasa Dengan Kejadian Diabetes Mellitus Tipe 2 Pada Pasien Usia 25-64 Tahun Di Puskesmas Kendal Kerep Kota Malang. Preventia Indones J Public Health. 2019;4(1):1-7. doi:10.17977/um044v4i1p56-62
30. Isnaini N, Ratnasari R. Faktor risiko mempengaruhi kejadian Diabetes mellitus tipe dua. Junal Kebidanan dan Keperawatan Aisyiyah. 2018;14(1):59-68. doi:10.31101/jkk.550
31. Geetha A, Gopalakrishnan S, Umadevi R. Study on the impact of family history of diabetes among type 2 diabetes mellitus patients in an urban area of Kancheepuram district, Tamil Nadu. Int J Community Med Public Health. 2017;4(11):4151-6. doi:10.18203/2394-6040.ijcmph20174819
32. Bernabe-Ortiz A, Perel P, Miranda JJ, Smeeth L. Diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM in Peruvian population. Prim Care Diabetes. 2018;12(6):517-25. doi:10.1016/j.pcd.2018.07.015
33. Waspadji S. Pengkajian Status Gizi: Studi Epidemiologi. Jakarta, Indonesia: Fakultas Kedokteran Universitas Indonesia; 2003.
34. Akobeng AK. Understanding diagnostic tests 1: sensitivity, specificity and predictive values. Acta Paediatr. 2007;96(3):338-41. doi:10.1111/j.1651-2227.2006.00180.x
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2. Ministry of Health of the Republic of Indonesia. InfoDatin Pusat Data dan Informasi Kementerian Kesehatan RI: Hari Diabetes Sedunia Tahun 2018. Jakarta, Indonesia: Ministry of Health of the Republic of Indonesia; 2018.
3. Soelistijo SA, Novida H, Rudijanto A, Soewondo P, Suastika K, Manaf A, et al. Konsensus Pengelolaan Dan Pencegahan Diabetes Melitus Tipe 2 Di Indonesia. Jakarta, Indonesia: Perkumpulan Endokrinologi Indonesia; 2015.
4. Wu Y, Ding Y, Tanaka Y, Zhang W. Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention. Int J Med Sci. 2014;11(11):1185-1200. doi:10.7150/ijms.10001
5. Costa B, Barrio F, Piñol JL, Cabré JJ, Mundet X, Sagarra R, et al. Shifting from glucose diagnosis to the new HbA1c diagnosis reduces the capability of the Finnish Diabetes Risk Score (FINDRISC) to screen for glucose abnormalities within a real-life primary healthcare preventive strategy. BMC Med. 2013;11:45. doi:10.1186/1741-7015-11-45
6. Dugee O, Janchiv O, Jousilahti P, Sakhiya A, Palam E, Nuorti JP, et al. Adapting existing diabetes risk scores for an Asian population: a risk score for detecting undiagnosed diabetes in the Mongolian population. BMC Public Health. 2015;15:938. doi:10.1186/s12889-015-2298-9
7. Tankova T, Chakarova N, Atanassova I, Dakovska L. Evaluation of the Finnish Diabetes Risk Score as a screening tool for impaired fasting glucose, impaired glucose tolerance and undetected diabetes. Diabetes Res Clin Pract. 2011;92(1):46-52. doi:10.1016/j.diabres.2010.12.020
8. Zhang L, Zhang Z, Zhang Y, Hu G, Chen L. Evaluation of Finnish Diabetes Risk Score in screening undiagnosed diabetes and prediabetes among U.S. adults by gender and race: NHANES 1999-2010. PLoS One. 2014;9(5):e97865. doi:10.1371/journal.pone.0097865
9. Mavrogianni C, Lambrinou CP, Androutsos O, Lindström J, Kivelä J, Cardon G. Evaluation of the Finnish Diabetes Risk Score as a screening tool for undiagnosed type 2 diabetes and dysglycaemia among early middle-aged adults in a large-scale European cohort. The Feel4Diabetes-study. Diabetes Res Clin Pract. 2019;150:99-110. doi:10.1016/j.diabres.2019.02.017
10. Štiglic G, Fijačko N, Stožer A, Sheikh A, Pajnkihar M. Validation of the Finnish Diabetes Risk Score (FINDRISC) questionnaire for undiagnosed type 2 diabetes screening in the Slovenian working population. Diabetes Res Clin Pract. 2016;120:194-7. doi:10.1016/j.diabres.2016.08.010
11. Kulkarni M, Foraker RE, McNeill AM, Girman C, Golden SH, Rosamond WD, et al. Evaluation of the Modified FINDRISC Diabetes Score to Identify Individuals at High Risk for Diabetes among Middle-aged White and Black ARIC Study Participants. Diabetes Obes Metab. 2017;19(9):1260-6. doi:10.1111/dom.12949
12. Hosmer DW, Lemeshow S, Sturdivant RX. Applied Logistic Regression. 3rd edition. New Jersey, US: John Wiley & Sons, Inc; 2013.
13. Hair Jr JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis. 7th edition. New Jersey, US: Prentice Hall; 2014.
14. International Diabetes Federation. International Diabetes Federation Diabetes Atlas. 9th edition. Brusesels, Belgium: International Diabetes Federation; 2019.
15. Saaristo T, Peltonen M, Lindström J, Saarikoski L, Sundvall J, Eriksson JG, et al. Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome. Diab Vasc Dis Res. 2005;2(2):67-72. doi:10.3132/dvdr.2005.011
16. Trisnawati SK, Setyorogo S. Faktor Risiko Kejadian Diabetes Melitus Tipe II Di Puskesmas Kecamatan Cengkareng Jakarta Barat Tahun 2012. Jurnal Ilmiah Kesehatan. 2013;5(1):6-11.
17. American Diabetes Association. Standards of Medical Care in Diabetes—2019 Abridged for Primary Care Providers. Clin Diabetes. 2019;37(1):11-34. doi:10.2337/cd18-0105
18. Song J, Lee WT, Park KA, Lee JE. Association between risk factors for vascular dementia and adiponectin. Biomed Res Int. 2014;2014:261672. doi:10.1155/2014/261672
19. Ekpenyong CE, Akpan UP, Ibu JO, Nyebuk DE. Gender and age specific prevalence and associated risk factors of type 2 diabetes mellitus in Uyo metropolis, South Eastern Nigeria. Diabetol Croat. 2012;41(1):17-28.
20. Steele CJ, Schöttker B, Marshall AH, Kouvonen A, O'Doherty MG, Mons U, et al. Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study: a population-based cohort study. BMJ Open. 2017;7(4):e013569. doi:10.1136/bmjopen-2016-013569
21. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes. 2014;7:587-91. doi:10.2147/dmso.s67400
22. Triwinarto A, Muljati S, Jahari AB. Cut-Off Point Indeks Massa Tubuh (Imt) Dan Lingkar Perut Sebagai Indikator Risiko Diabetes Dan Hipertensi Pada Orang Dewasa Di Indonesia. Penelitian Gizi Makanan J Nutr Food Res. 2012;35(2):119-35.
23. Septyaningrum N, Santi M. Lingkar Perut Mempunyai Hubungan Paling Kuat Dengan Kadar Gula Darah. Jurnal Berkala Epidemiologi. 2014;2(1):48-58. doi:10.20473/jbe.V2I12014.48-58
24. Nurayati L, Adriani M. Hubungan Aktifitas Fisik Dengan Kadar Gula Darah Puasa Penderita Diabetes Melitus Tipe 2. Amerta Nutr. 2017;1(2):80-7. doi:10.20473/amnt.v1i2.2017.80-87
25. Li M, Fan Y, Zhang X, Hou W, Tang Z. Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies. BMJ Open. 2014;4(11):e005497. doi:10.1136/bmjopen-2014-005497
26. Bazzano LA, Serdula MK, Liu S. Dietary intake of fruits and vegetables and risk of cardiovascular disease. Curr Atheroscler Rep. 2003;5(6):492-9. doi:10.1007/s11883-003-0040-z
27. Taylor EN, Hu FB, Curhan GC. Antihypertensive Medications and the Risk of Incident Type 2 Diabetes. Diabetes Care. 2006;29(5):1065-70. doi:10.2337/dc05-2366
28. Weycker D, Edelsberg J, Vincze G, Kjeldsen SE, Jamerson K, Khan ZM, et al. Risk of diabetes in a real-world setting among patients initiating antihypertensive therapy with valsartan or amlodipine. J Hum Hypertens. 2007;21(5):374-80. doi:10.1038/sj.jhh.1002159
29. Gayatri RW. Hubungan Faktor Riwayat Diabetes Mellitus Dan Kadar Gula Darah Puasa Dengan Kejadian Diabetes Mellitus Tipe 2 Pada Pasien Usia 25-64 Tahun Di Puskesmas Kendal Kerep Kota Malang. Preventia Indones J Public Health. 2019;4(1):1-7. doi:10.17977/um044v4i1p56-62
30. Isnaini N, Ratnasari R. Faktor risiko mempengaruhi kejadian Diabetes mellitus tipe dua. Junal Kebidanan dan Keperawatan Aisyiyah. 2018;14(1):59-68. doi:10.31101/jkk.550
31. Geetha A, Gopalakrishnan S, Umadevi R. Study on the impact of family history of diabetes among type 2 diabetes mellitus patients in an urban area of Kancheepuram district, Tamil Nadu. Int J Community Med Public Health. 2017;4(11):4151-6. doi:10.18203/2394-6040.ijcmph20174819
32. Bernabe-Ortiz A, Perel P, Miranda JJ, Smeeth L. Diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM in Peruvian population. Prim Care Diabetes. 2018;12(6):517-25. doi:10.1016/j.pcd.2018.07.015
33. Waspadji S. Pengkajian Status Gizi: Studi Epidemiologi. Jakarta, Indonesia: Fakultas Kedokteran Universitas Indonesia; 2003.
34. Akobeng AK. Understanding diagnostic tests 1: sensitivity, specificity and predictive values. Acta Paediatr. 2007;96(3):338-41. doi:10.1111/j.1651-2227.2006.00180.x
Authors
1.
Pertiwi P, Perwitasari DA, Satibi S. Validation of Finnish Diabetes Risk Score Indonesia Version in Yogyakarta. Borneo J Pharm [Internet]. 2021Feb.28 [cited 2025Apr.16];4(1):57-6. Available from: https://journal.umpr.ac.id/index.php/bjop/article/view/1575
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