Australian Type 2 Diabetes Risk (AUSDRISK) Assessment Tool

AUSDRISK Assessment Tool

Age

Sex

Ethnicity

Family History of Diabetes

History of High Blood Glucose

Currently on Antihypertensive Medication

Current Smoker

Fruit/Vegetables Daily

Physical Activity (≥150 min/week)

Waist Circumference

Score:–

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Estimates risk of developing type 2 diabetes, mainly in Australian patients.

Why Use

Includes only non-invasive variables. Provides objective score to help support recommendations of lifestyle modification to patients by primary care physicians. In identified high-risk patients, enables further investigation and appropriate management of risk and lifestyle factors to prevent the development of diabetes. In Australia, AUSDRISK score ≥12 is a prerequisite for physician access to Medicare items for health assessment of patients in the 40-49 age group.

When to Use

Primary care lifestyle screening for adults ≥25 years of age.

Formula

Variable Points Age 25-34 35-44 45-54 55-64 ≥65 0 2 4 6 8 Sex Female Male 0 3 Ethnicity Also used to determine waist circumference categories; see below Southern European Asian Aboriginal/Torres Strait Islander Pacific Islander Other 2 2 2 2 0 Parental history of diabetes No Yes 0 3 History of high blood glucose* No Yes 0 6 Use of antihypertensive medications No Yes 0 2 Current smoker No Yes 0 2 Physical inactivity** No Yes 0 2 Waist circumference*** Category 1 Category 2 Category 3 0 4 7 BMI Note : In the study, several models were tested in terms of quantifying obesity; per first author Dr. Lei Chen, the addition of BMI does not significantly increase discriminatory power (see Creator Insights for further detail), but may be used in cases where waist circumference cannot be accurately measured. Normal (<25) Overweight (25 to less than 30) Obese (30 to less than 35) Morbidly obese (≥35) 0 3 6 8 *Patients were asked if they had ever been told their glucose level was high, including during pregnancy for women. **Physical inactivity was defined as less than 150 minutes per week of walking (if continuous and ≥10 minutes) and/or moderate or vigorous activity. ***For Aboriginal/Torres Strait Islander or Asian background: Category 1: <90 cm (men), <80 cm (women) Category 2: 90–99 cm (men), 80–89 cm (women) Category 3: ≥100 cm (men), ≥90 cm (women) For Southern European, Pacific Islander, or other: Category 1: <102 cm (men), <88 cm (women) Category 2: 102–109 cm (men), 88–99 cm (women) Category 3: ≥110 cm (men), ≥100 cm (women) From Chen 2010 .

Pearls / Pitfalls

The Australian Type 2 Diabetes Risk (AUSDRISK) Assessment Tool identifies Australian adults at high risk for developing diabetes based on demographic, lifestyle, and simple anthropometric measures. Targeted for use in primary care screening. Enables identification of high risk individuals for focused lifestyle counseling and/or further investigation. Developed specifically for the Australian population but has allowance for ethnicity and country of birth, so it may have validity in other countries with similar demographics. Has been validated in a separate study examining an external cohort of Dutch patients. May overestimate risk in patients <25 years. Some versions of the AUSDRISK eliminate BMI, but the authors found that it resulted in a loss of discriminatory power.

Management

In Australia, patients with scores ≥12 should be investigated for possible diabetes and enrolled for advice regarding diet, weight control, and exercise. Diagnostic criteria for diabetes (Australia): Fasting blood glucose (FBG) ≥7.0 mmol/L, confirmed by a second reading on a separate day OR Oral glucose tolerance test (OGTT) showing FBG ≥7.0 mmol/L or 2-hour blood glucose ≥11.1mmol/L OR Hemoglobin A1c (HgbA1c) ≥48 mmol/mol (6.5%) on two separate occasions.

Critical Actions

Monitor for symptomatic diabetes (e.g. polyuria, polydipsia, loss of sensation).

More Information

AUSDRISK Score 5-year Risk* of Type 2 DM <5 1 in 100 6-8 1 in 50 9-11 1 in 30 12-15 1 in 14 16-19 1 in 7 >20 1 in 3 May overestimate risk in patients <25 years old and may underestimate risk in Aboriginal and Torres Strait Islanders. From General Practice Management Guidelines of Type 2 DM, Royal Australian College of General Practitioners 2016 .