Saudi Arabia has one of the highest prevalence rates of type 2 diabetes in the world, with one in five of people living with the disease. It represents a major clinical and public health problem, as an uncontrolled blood glucose level can lead to serious complications, including blindness, kidney failure and cardiovascular disease.

Over the past two decades, healthcare expenditure and treatment for diabetes in Saudi Arabia increased more than 500%, straining the healthcare system. This prompted Rajaa Al-Raddadi at King Abdulaziz University (KAU), Jeddah, and colleagues from KAU and KAIMRC to develop a tool that identifies individuals at high-risk of developing type 2 diabetes. By recruiting 1403 Saudis with diabetes or prediabetes, they developed the Saudi Diabetes Risk Score (SADRISC), which they hope will help improve diabetes prevention programmes in Saudi Arabia and reduce the economic burden of the disease.

The major risk factors for type 2 diabetes are well established. Some are genetic, but many others can be reduced by lifestyle changes. Low-carbohydrate diets and exercise, for example, have been shown to help reduce insulin levels and prevent the development of type 2 diabetes.

Abnormalities in blood sugar levels, known as dysglycemia, are one of the first tell-tale signs of type 2 diabetes. In most cases, however, slightly higher than normal blood sugar levels can go unnoticed for several years, leading to further deterioration in metabolic regulation and progression to diabetes.

Detecting dysglycemia requires specific laboratory tests that are impractical for assessing the risk of diabetes in large population screening programmes. However, participant-completed questionnaires can help determine a Diabetes Risk Score that can be used to identify individuals with prediabetes or asymptomatic type 2 diabetes, who are likely to benefit from early intervention.

Because of differences in genetics and lifestyle, these questionnaires need to be adapted to different populations. Al-Raddadi and colleagues collected demographic and clinical data to select the most relevant variables for a non-invasive, easy screening questionnaire that identifies adults with undiagnosed diabetes in Saudi Arabia.

To make their tool more inclusive than previous attempts, the researchers recruited participants from five areas in Jeddah to ensure a spread of socioeconomic sectors and ethnicities living in Saudi Arabia was represented.  In addition, data collection was carried out by well-trained medical students using standardized instruments to improve the accuracy of the results.

The SADRISC comprises only five variables: sex, age, waist circumference, history of hyperglycemia and family history of diabetes, and score values range from 0 to 15. If someone scores 5 or 6 on the scale, then it would suggest with a 75% accuracy that this individual is at high risk of developing diabetes.

The researchers are now working with health professionals and the Ministry of Health, to introduce SADRISC into national diabetes prevention programmes aimed at reducing the incidence of the condition.

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