Research Article 
The Finnish Diabetes Risk Score is associated with insulin resistance but not reduced β-cell function, by classical and model-based estimates
K. G. Brodovicz, J. M. Dekker, J.M. Rijkelijkhuizen, T. Rhodes, A. Mari, M. Alssema, G. Nijpels, D.E. Williams-Herman and C. J. Girman
Diabetic Medicine, 2011, 28(9), 1078-1081. DOI: 10.1111/j.1464-5491.2011.03315.x
Abstract
Aims The Finnish Diabetes Risk Score (FINDRISC) is widely used for risk stratification in Type 2 diabetes prevention programmes. Estimates of β-cell function vary widely in people without diabetes and reduced insulin secretion has been described in people at risk for diabetes. The aim of this analysis was to evaluate FINDRISC as a tool to characterize reduced β-cell function in individuals without known diabetes. Methods In this population-based cohort from the Hoorn municipal registry, subjects received an oral glucose tolerance test and a meal tolerance test on separate days, in random order, within 2 weeks. One hundred and eighty-six subjects, age 41-66 years, with no known Type 2 diabetes were included. Of those, 163 (87.6%) had normal glucose metabolism and 23 (12.4%) had abnormal glucose metabolism (19 with impaired glucose metabolism; four with newly diagnosed Type 2 diabetes based on study results). Insulin sensitivity and β-cell function (classical: insulinogenic index; ratio of areas under insulin/glucose curves; model-based: glucose sensitivity; rate sensitivity; potentiation) estimates were calculated from oral glucose tolerance test and meal tolerance test data. Results FINDRISC was associated with insulin sensitivity (r = -0.41, P < 0.0001), insulin/glucose areas under the curve (meal tolerance test: r = 0.29, P < 0.0001; oral glucose tolerance test: r = 0.21, P = 0.01) and potentiation factor (meal tolerance test: r = 0.21, P = 0.01). After adjusting for insulin sensitivity, these associations with β-cell function were no longer significant. Conclusions After adjustment for insulin sensitivity, FINDRISC was not associated with reduced β-cell function in subjects without known Type 2 diabetes. While insulin secretion and insulin sensitivity are both components in Type 2 diabetes development, insulin sensitivity appears to be the dominant component behind the association between FINDRISC and diabetes risk.
ASCI-ID: 109-380
Similar Articles
Non-esterified fatty acid dynamics during oral glucose tolerance test in women with former gestational diabetes
Diabetic Medicine, 2012, 29(3), 351-358. DOI: 10.1111/j.1464-5491.2011.03477.x
Exenatide plus metformin compared with metformin alone on β-cell function in patients with Type 2 diabetesDiabetic Medicine, 2012, 29(12), 1515-1523. DOI: 10.1111/j.1464-5491.2012.03699.x
A comparison between sitagliptin or glibenclamide in addition to metformin + pioglitazone on glycaemic control and β-cell function: the triple oral therapyDiabetic Medicine, 2013, 30(7), 846-854. DOI: 10.1111/dme.12158
Feasibility of the FINDRISC questionnaire to identify individuals with impaired glucose tolerance in Swedish primary care. A cross-sectional population-based studyDiabetic Medicine, 2012, 29(12), 1501-1505. DOI: 10.1111/j.1464-5491.2012.03664.x
Addressing insulin resistance in Type 1 diabetesDiabetic Medicine, 2008, 25(9), 1015-1024.
Relationship between γ-glutamyltransferase and metabolic syndrome in a Korean populationDiabetic Medicine, 2008, 25(4), 469-475. DOI: 10.1111/j.1464-5491.2008.02415.x
Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use: results from GEMINIDiabetic Medicine, 2007, 24(7), 759-763. DOI: 10.1111/j.1464-5491.2007.02151.x
Impact of 3-year lifestyle intervention on postprandial glucose metabolism: the SLIM studyDiabetic Medicine, 2008, 25(5), 597-605. DOI: 10.1111/j.1464-5491.2008.02417.x
Comparison of effects of combined ACE inhibitor and low-dose thiazide diuretic with ACE inhibitor alone on insulin action in patients with hypertension and Type 2 diabetes: a double-blind crossover studyDiabetic Medicine, 2008, 25(5), 631-634. DOI: 10.1111/j.1464-5491.2008.02437.x
Mechanisms of glucose intolerance in cystic fibrosisDiabetic Medicine, 2009, 26(6), 582-588. DOI: 10.1111/j.1464-5491.2009.02738.x
The effect of rosiglitazone on insulin sensitivity and mid-thigh low-density muscle in patients with Type 2 diabetesDiabetic Medicine, 2010, 27(1), 30-36. DOI: 10.1111/j.1464-5491.2009.02897.x
Do high ferritin levels confer lower cardiovascular risk in men with Type 2 diabetes?Diabetic Medicine, 2010, 27(4), 417-422. DOI: 10.1111/j.1464-5491.2010.02979.x
Alcohol drinking, the metabolic syndrome and diabetes in a population with high mean alcohol consumptionDiabetic Medicine, 2010, 27(11), 1241-1249. DOI: 10.1111/j.1464-5491.2010.03094.x
Association of insulin sensitivity to lipids across the lifespan in people with Type 1 diabetesDiabetic Medicine, 2011, 28(2), 148-155. DOI: 10.1111/j.1464-5491.2010.03143.x
Differences in the implications of maternal lipids on fetal metabolism and growth between gestational diabetes mellitus and control pregnanciesDiabetic Medicine, 2011, 28(9), 1053-1059. DOI: 10.1111/j.1464-5491.2011.03346.x
Effects of a single post-partum injection of a high dose of vitamin D on glucose tolerance and insulin resistance in mothers with first-time gestational diabetes mellitusDiabetic Medicine, 2012, 29(1), 36-42. DOI: 10.1111/j.1464-5491.2011.03473.x
Differences in insulin resistance and pancreatic B-cell function in obese subjects with isolated impaired glucose tolerance and isolated impaired fasting glucoseDiabetic Medicine, 2008, 25(1), 73-79. DOI: 10.1111/j.1464-5491.2007.02329.x
Elevated glucose concentrations during an oral glucose tolerance test are associated with the presence of metabolic syndrome in childhood obesityDiabetic Medicine, 2008, 25(3), 289-295. DOI: 10.1111/j.1464-5491.2007.02380.x
Serum bicarbonate, anion gap and insulin resistance in the National Health and Nutrition Examination SurveyDiabetic Medicine, 2008, 25(7), 798-804. DOI: 10.1111/j.1464-5491.2008.02471.x
Strong association between insulin resistance in liver and skeletal muscle in non-diabetic subjectsDiabetic Medicine, 2008, 25(11), 1289-1294. DOI: 10.1111/j.1464-5491.2008.02597.x
Severe insulin resistance due to anti-insulin antibodies: response to plasma exchange and immunosuppressive therapyDiabetic Medicine, 2009, 26(1), 79-82. DOI: 10.1111/j.1464-5491.2008.02621.x
Insulin resistance is an independent correlate of increased urine albumin excretion: a cross-sectional study in Iranian Type 2 diabetic patientsDiabetic Medicine, 2009, 26(2), 177-181. DOI: 10.1111/j.1464-5491.2008.02653.x
Factors determining normalization of glucose intolerance in middle-aged Swedish men and women: a 8-10-year follow-upDiabetic Medicine, 2009, 26(4), 345-353. DOI: 10.1111/j.1464-5491.2009.02685.x
Altered respiratory function is associated with increased metabolic risk, independently of adiposity, fitness and physical activityDiabetic Medicine, 2009, 26(4), 362-369. DOI: 10.1111/j.1464-5491.2009.02689.x
J-shaped relationship between waist circumference and subsequent risk for Type 2 diabetes: an 8-year follow-up of relatively lean Japanese individualsDiabetic Medicine, 2009, 26(8), 753-759. DOI: 10.1111/j.1464-5491.2009.02773.x
Following in mother's footsteps? Mother-daughter risks for insulin resistance and cardiovascular disease 15 years after gestational diabetesDiabetic Medicine, 2010, 27(3), 257-265. DOI: 10.1111/j.1464-5491.2010.02944.x
The high prevalence of malnutrition in elderly diabetic patients: implications for anti-diabetic drug treatmentsDiabetic Medicine, 2010, 27(8), 918-924. DOI: 10.1111/j.1464-5491.2010.03047.x
Increased maternal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) associated with older age at diagnosis of Type 1 diabetes in offspringDiabetic Medicine, 2010, 27(12), 1450-1453. DOI: 10.1111/j.1464-5491.2010.03130.x
Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetesDiabetic Medicine, 2011, 28(5), 549-559. DOI: 10.1111/j.1464-5491.2010.03209.x
Blood glucose control and quality of health care in non-insulin-treated patients with Type 2 diabetes in Spain: a retrospective and cross-sectional observational studyDiabetic Medicine, 2011, 28(6), 731-740. DOI: 10.1111/j.1464-5491.2011.03258.x
The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetesDiabetic Medicine, 2011, 28(8), 972-975. DOI: 10.1111/j.1464-5491.2011.03284.x
Sleep disturbances and insulin resistanceDiabetic Medicine, 2011, 28(12), 1455-1462. DOI: 10.1111/j.1464-5491.2011.03459.x
Insulin resistance and pathological brain ageingDiabetic Medicine, 2011, 28(12), 1463-1475. DOI: 10.1111/j.1464-5491.2011.03464.x
Mechanistic insights into insulin resistance in the genetic eraDiabetic Medicine, 2011, 28(12), 1476-1486. DOI: 10.1111/j.1464-5491.2011.03463.x
Measurement of insulin action: a tribute to Sir Harold HimsworthDiabetic Medicine, 2011, 28(12), 1487-1493. DOI: 10.1111/j.1464-5491.2011.03409.x
The immune marker soluble urokinase plasminogen activator receptor is associated with new-onset diabetes in non-smoking women and menDiabetic Medicine, 2012, 29(4), 479-487. DOI: 10.1111/j.1464-5491.2011.03513.x
Impact of increased visceral and cardiac fat on cardiometabolic risk and diseaseDiabetic Medicine, 2012, 29(5), 622-627. DOI: 10.1111/j.1464-5491.2011.03503.x
Disordered insulin secretion in the development of insulin resistance and Type 2 diabetesDiabetic Medicine, 2012, 29(8), 972-979. DOI: 10.1111/j.1464-5491.2012.03655.x
Hyperbaric oxygen therapy improves peripheral insulin sensitivity in humansDiabetic Medicine, 2012, 29(8), 986-989. DOI: 10.1111/j.1464-5491.2012.03587.x
Vitamin D and diabetes in Koreans: analyses based on the Fourth Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2009Diabetic Medicine, 2012, 29(8), 1003-1010. DOI: 10.1111/j.1464-5491.2012.03575.x
" style="text-decoration:none">Dorothy Hodgkin Lecture 2012 Non-alcoholic fatty liver disease, insulin resistance and ectopic fat: a new problem in diabetes managementDiabetic Medicine, 2012, 29(9), 1098-1107. DOI: 10.1111/j.1464-5491.2012.03732.x
Macular oedema is not predicted by perifoveal single blot haemorrhagesDiabetic Medicine, 2008, 25(2), 129-133. DOI: 10.1111/j.1464-5491.2007.02330.x
Notification of random hyperglycaemia to general practitioners by an emergency medicine team: impact of a simple intervention planDiabetic Medicine, 2008, 25(6), 751-754. DOI: 10.1111/j.1464-5491.2008.02447.x
Socioeconomic factors related to attendance at a Type 2 diabetes screening programmeDiabetic Medicine, 2009, 26(5), 518-525. DOI: 10.1111/j.1464-5491.2009.02715.x
Trends in yield and effects of screening intervals during 17 years of a large UK community-based diabetic retinopathy screening programmeDiabetic Medicine, 2009, 26(10), 1040-1047. DOI: 10.1111/j.1464-5491.2009.02820.x
Performance of HbA1c for detecting newly diagnosed diabetes and pre-diabetes in Chinese communities living in BeijingDiabetic Medicine, 2009, 26(12), 1262-1268. DOI: 10.1111/j.1464-5491.2009.02831.x
A national survey of the current state of screening services for diabetic retinopathy: ABCD–Diabetes UK survey of specialist diabetes services 2006Diabetic Medicine, 2009, 26(12), 1301-1305. DOI: 10.1111/j.1464-5491.2009.02838.x
Performance of existing risk scores in screening for undiagnosed diabetes: an external validation studyDiabetic Medicine, 2010, 27(1), 46-53. DOI: 10.1111/j.1464-5491.2009.02891.x
A simple risk score to identify Southern Chinese at high risk for diabetesDiabetic Medicine, 2010, 27(6), 644-649. DOI: 10.1111/j.1464-5491.2010.02993.x
The importance of postpartum glucose tolerance testing after pregnancies complicated by gestational diabetesDiabetic Medicine, 2010, 27(6), 650-654. DOI: 10.1111/j.1464-5491.2010.03001.x
Undiagnosed diabetes in the over-60s: performance of the Association of Public Health Observatories (APHO) Diabetes Prevalence Model in a general practiceDiabetic Medicine, 2012, 29(1), 115-120. DOI: 10.1111/j.1464-5491.2011.03389.x
Undiagnosed diabetes-data from the English longitudinal study of ageingDiabetic Medicine, 2009, 26(7), 679-685. DOI: 10.1111/j.1464-5491.2009.02755.x
Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk populationDiabetic Medicine, 2009, 26(8), 760-765. DOI: 10.1111/j.1464-5491.2009.02765.x
Reliability of screening methods for diabetic retinopathyDiabetic Medicine, 2009, 26(8), 783-790. DOI: 10.1111/j.1464-5491.2009.02778.x
Validation of an algorithm combining haemoglobin A1c and fasting plasma glucose for diagnosis of diabetes mellitus in UK and Australian populationsDiabetic Medicine, 2009, 26(2), 115-121. DOI: 10.1111/j.1464-5491.2008.02652.x
How much might cardiovascular disease risk be reduced by intensive therapy in people with screen-detected diabetes?Diabetic Medicine, 2008, 25(12), 1433-1439. DOI: 10.1111/j.1464-5491.2008.02600.x
Socio-economic and ethnic inequalities in diabetes retinal screeningDiabetic Medicine, 2010, 27(3), 282-288. DOI: 10.1111/j.1464-5491.2010.02946.x
The Leicester Risk Assessment score for detecting undiagnosed Type 2 diabetes and impaired glucose regulation for use in a multiethnic UK settingDiabetic Medicine, 2010, 27(8), 887-895. DOI: 10.1111/j.1464-5491.2010.03037.x
The prevalence of depressive symptoms in a white European and South Asian population with impaired glucose regulation and screen-detected Type 2 diabetes mellitus: a comparison of two screening toolsDiabetic Medicine, 2010, 27(8), 896-905. DOI: 10.1111/j.1464-5491.2010.03042.x
Who attends a UK diabetes screening programme? Findings from the ADDITION-Cambridge studyDiabetic Medicine, 2010, 27(9), 995-1003. DOI: 10.1111/j.1464-5491.2010.03056.x
Agreement and reasons for disagreement between photographic and hospital biomicroscopy grading of diabetic retinopathyDiabetic Medicine, 2011, 28(6), 741-746. DOI: 10.1111/j.1464-5491.2011.03273.x
Measuring the accuracy of different ways to identify the ‘at-risk’ foot in routine clinical practiceDiabetic Medicine, 2011, 28(6), 747-754. DOI: 10.1111/j.1464-5491.2011.03297.x
The association between anxiety and measures of glycaemia in a population-based diabetes screening programmeDiabetic Medicine, 2011, 28(7), 785-788. DOI: 10.1111/j.1464-5491.2011.03245.x
Screening for Type 2 diabetes. Lessons from the ADDITION-Europe studyDiabetic Medicine, 2011, 28(11), 1416-1424. DOI: 10.1111/j.1464-5491.2011.03365.x
Establishing an evidence base for frequency of monitoring glycated haemoglobin levels in patients with Type 2 diabetes: projections of effectiveness from a regression modelDiabetic Medicine, 2012, 29(2), 266-271. DOI: 10.1111/j.1464-5491.2011.03412.x
Validity of self-assessed waist circumference in a multi-ethnic UK populationDiabetic Medicine, 2012, 29(3), 404-409. DOI: 10.1111/j.1464-5491.2011.03478.x
A simple strategy for screening for glucose intolerance, using glycated haemoglobin, in individuals admitted with acute coronary syndromeDiabetic Medicine, 2012, 29(7), 838-843. DOI: 10.1111/j.1464-5491.2012.03643.x
Effect of screening for Type 2 diabetes on population-level self-rated health outcomes and measures of cardiovascular risk: 13-year follow-up of the Ely cohortDiabetic Medicine, 2012, 29(7), 886-892. DOI: 10.1111/j.1464-5491.2012.03570.x
The cost of diagnosing Type 2 diabetes mellitus by clinical opportunistic screening in general practiceDiabetic Medicine, 2012, 29(7), 863-868. DOI: 10.1111/j.1464-5491.2012.03607.x
Estimating the potential population impact of stepwise screening strategies for identifying and treating individuals at high risk of Type 2 diabetes: a modelling studyDiabetic Medicine, 2012, 29(7), 893-904. DOI: 10.1111/j.1464-5491.2012.03609.x
Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A reviewDiabetic Medicine, 2012, 29(7), 844-854. DOI: 10.1111/j.1464-5491.2011.03541.x
Blood glucose testing and primary prevention of Type 2 diabetes-evaluation of the effect of evidence-based patient information: a randomized controlled trialDiabetic Medicine, 2012, 29(8), 1011-1020. DOI: 10.1111/j.1464-5491.2011.03531.x
Screening for diabetic retinopathy in pregnancy using photographic review clinicsDiabetic Medicine, 2013, 30(4), 475-477. DOI: 10.1111/dme.12077