• Catarina Schiborn, Rebecca Paprott, Christin Heidemann, Tilman Kühn, Andreas Fritsche, Rudolf Kaaks, and Matthias B Schulze.
• Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal; German Center for Diabetes Research (DZD), Munich; Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), Berlin; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg; Institute for Global Food Security, Queen's University Belfast, Belfast, UK; Department of Medicine IV, University Hospital Tübingen; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen; Institute of Nutritional Science, University of Potsdam, Nuthetal.
• Dtsch Arztebl Int. 2022 Sep 30; 119 (39): 651657651-657.

BackgroundThe German Diabetes Risk Score (GDRS) currently enables prediction of the individual risk of developing type 2 diabetes (T2D) within five years. The aim of this study is to extend the prediction period of the GDRS, including its non-clinical version and its HbA1c extension, to 10 years, and to perform external validation.MethodsIn data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study (n = 25 393), Cox proportional hazards regression was used to reweight the points that were used to calculate the five-year risk. Two population-based prospective cohorts (EPIC-Heidelberg n = 23 624, GNHIES98 cohort n = 3717) were used for external validation. Discrimination was represented by C-indices, and calibration by calibration plots and the expected-to-observed (E/O) ratio.ResultsPrediction performance in EPIC-Potsdam was very good (C-index for the non-clinical model: 0.834) and was confirmed in EPIC-Heidelberg (0.843) and in the GNHIES98 cohort (0.851). Among persons in the GNHIES98 cohort with a greater than 10% predicted probability of disease, 14.9% developed T2D within 10 years (positive predictive value). The models were very well calibrated in EPIC-Potsdam (E/O ratio for the non-clinical model: 1.08), slightly overestimated the risk in EPIC-Heidelberg (1.34), and predicted T2D very well in the GNHIES98 cohort after recalibration (1.06).ConclusionThe extended GDRS prediction period of 10 years, with a non-clinical version and an HbA1c extension that will soon be available in both German and English, enables the even longer-range, evidence-based identification of high-risk individuals with many different applications, including medical screening.

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