Chinese 6-Year Diabetes Risk Score

Which Chinese diabetes score is this?

This score looks ahead. It estimates the chance that someone aged 50 to 70 who does not have diabetes now will develop type 2 diabetes within 6 years, and it needs blood test results (Ye 2014). The Chinese Diabetes Risk Score answers a different question: whether you may already have diabetes without knowing it. It needs no blood test (Zhou 2013). If you have no recent blood test, start there. The Japanese diabetes risk score looks 3 years ahead (Nanri 2015), and the FINDRISC calculator from Finland looks 10 years ahead (Lindström 2003).

The points

Points from Table 2 of the paper (Ye 2014). The paper first printed the CRP unit as mmol/L. A correction later in 2014 changed it to mg/L (Ye 2014). CRP was measured with a high-sensitivity test, and the three CRP groups are the thirds of the study's own values. High blood pressure meant 140/90 mmHg or more, or taking blood pressure medicine (Ye 2014). Fasting glucose in mg/dL divided by 18 gives mmol/L, so 5.6 and 6.1 mmol/L are about 101 and 110 mg/dL.

Example: a 58-year-old woman with a BMI of 25, normal blood pressure, a fasting glucose of 5.8 mmol/L, an HbA1c of 5.7% and a CRP of 0.5 mg/L scores 1 (female) + 1 (BMI) + 3 (glucose) + 2 (HbA1c) + 1 (CRP) = 8. Table 2 puts the 6-year chance of diabetes at a score of 8 at 61% (Ye 2014).

What the score means

Table 2 turns each total into an estimated chance of developing type 2 diabetes within 6 years. It runs from 20% at a score of 0 to 92% at 17 (Ye 2014). These figures are high because 924 of the 1,912 people developed diabetes during the study, and 72.4% of the new cases were found by an HbA1c of 6.5% or more (Ye 2014). In a group where diabetes is less common, the same score would likely mean a lower chance.

A score of 7 or more was the cut point that best balanced finding future cases against flagging people who stayed free of diabetes. It picked up 55.5% of the people who went on to get diabetes, and 75.4% of those who did not scored under 7. The points score separated the two groups with an area under the curve of 0.714 (95% CI 0.691 to 0.737), better than the other East Asian scores the authors tested in the same people (Ye 2014). The authors say the score has not been checked in a separate group of people and may not fit outside ages 50 to 70 (Ye 2014).

What to do with your result

A score at or above the cut point is a reason to ask your doctor about follow-up blood sugar tests and about steps that lower diabetes risk, such as weight loss and more activity. A score below it does not rule diabetes out. If your fasting glucose is 7.0 mmol/L (126 mg/dL) or more, or your HbA1c is 6.5% or more, the calculator will not score you. Those values are in the diabetes range, and the study left such people out (Ye 2014). In the US, the US Preventive Services Task Force recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 who have overweight or obesity (USPSTF 2021), whatever any risk score says.

See also the Chinese Diabetes Risk Score, the Japanese diabetes risk score, the Korean diabetes risk score, the FINDRISC calculator, the A1C to average glucose converter, prediabetes ranges and next steps and the BMI calculator.