Assessment of HbA1c Performance and the Finnish Diabetes Risk Score in the Screening of Prediabetes in Young Adults.

Introduction. The prevalence of prediabetes in young people has increased considerably. Its early detection could prevent the progression to full-blown diabetes. This study aims to evaluate the diagnostic performance of HbA1c and the Finnish Diabetes Risk Score (FINDRISC) in the detection of prediabetes in young people. Materials and methods. We conducted a cross-sectional study with analytical aims over a period of 8 months, including 150 young adults aged 18 to 35 years, who went to the biochemistry laboratory of the Annaba University Hospital to take a fasting blood sample for the measurement of serum glycemia and HbA1c on whole blood. A questionnaire based on the FINDRISC score was used for data collection. Prediabetes was defined by a fasting glycemia between 5.6 mmol/L and 6.9 mmol/L. Data analysis was performed using IBM SPSS Statistics 20 software. Diagnostic performance was assessed by analyzing Receiver Operating Characteristic (ROC) curves and their area under the curve (AUC). Results. 12.8% of the population examined was classified as prediabetic. ROC curve analysis for HbA1c revealed an area under the curve (AUC) of 0.658 (95% CI: 0.497-0.819). Diagnostic performance obtained for an estimated HbA1c cutoff value of 5.35% indicates moderate sensitivity (68%), low specificity (58%), excellent negative predictive value (92%), and an overall accuracy of 59%. Regarding the FINDRISC score, the analysis showed an area under the curve (AUC) of 0.578 (95% CI: 0.445-0.710). The performances, associated with a score of 7.5 points, included a low sensitivity (26%), a moderate specificity (59%) and a very high negative predictive value (84%). Conclusion. This study highlights the limitations of HbA1c and the FINDRISC score as screening tools for prediabetes in young adults. Their low sensitivities and specificities call into question their diagnostic relevance in this population.