Evaluation of Capillary Blood Glucose and Chinese Diabetes Risk Score in Screening for Diabetes and Prediabetes Among Elderly Chinese Population: A Cross-Sectional Study

Background: With the prevalence of diabetes on the rise, healthcare systems worldwide are facing a serious burden. This study aims to explore the performance of fingertip capillary blood glucose (CBG), the Chinese Diabetes Risk Score (CDRS) and their combined application in identifying diabetes and prediabetes using glycosylated hemoglobin as a diagnostic criterion. Methods: We conducted a cross-sectional study from April to September 2022, involving 6868 urban and rural residents aged 60 and above in Qiyang City, Hunan Province. We utilized a logistic regression model combined with Receiver Operating Characteristic (ROC) curves to analyze and evaluate the effectiveness of using CBG alone or in conjunction with the CDRS for screening diabetes and prediabetes. Results: The prevalence of diabetes mellitus and prediabetes mellitus was 21.6% and 33.9%, respectively, among the 6868 elderly people. The area under the ROC curve (AUCs) of FCBG (fasting capillary blood glucose), the CDRS≥25 and FCBG+CDRS≥25 for detecting diabetes (prediabetes) were 0.756 (0.571), 0.570 (0.552) and 0.773 (0.590), respectively. The AUCs of RCBG (random capillary blood glucose), the CDRS≥25 and RCBG+CDRS≥25 in identifying diabetes (prediabetes) were 0.769 (0.590), 0.542 (0.526), and 0.775 (0.593), respectively. Conclusion: In large-scale community screening in China, CBG is more effective than CDRS for detecting diabetes in the elderly. The combination of the CDRS and CBG provides a practical and efficient strategy that could improve community-based screening efficiency for diabetes in the elderly. However, the limited accuracy of CBG and CDRS for prediabetes highlights the need for more specific methods in screening this condition.