The Usefulness of the Canadian Diabetes Risk Assessment Questionnaire (CANRISK) in Predicting Dysglycemia in Women with Histories of Gestational Diabetes

Objectives: In Canada, approximately 20% of women with gestational diabetes (GDM) are diagnosed with type 2 diabetes by 9 years postpartum; therefore, regular screening for type 2 diabetes is recommended. Diabetes risk assessment questionnaires, such as the Canadian Diabetes Risk Assessment Questionnaire (CANRISK), may be used to inform screening strategies. However, CANRISK was developed to estimate personal diabetes risk for individuals >40 years old. Many postpartum women with GDM are <40 years old at the time of screening, so the utility of CANRISK in this population has not been established. The study sought to determine whether CANRISK accurately classifies women with histories of GDM in the appropriate 10-year risk categories for developing type 2 diabetes and whether it is equally useful in classifying dysglycemia in those women by age (i.e. <40 and >40 years). Methods: A retrospective analysis was made of a cohort of Canadian women with GDM who were followed for 8 to 10 years postpartum. Women with oral glucose tolerance test results at the study's end were included, and had CANRISK scores calculated. Measures of diagnostic accuracy for CANRISK were calculated by dysglycemia status using the oral glucose tolerance test as the gold standard. Results: Included in the study were 74 women. In women <40 years old, 17% with dysglycemia were missed, and 79% without dysglycemia had unnecessary laboratory testing. In women >40 years old, the CANRISK correctly classified 26 of 28 (92.9%) as being at "moderate" to "very high risk" for dysglycemia, thereby requiring further laboratory testing (p = 0.03). Conclusions: CANRISK was not clinically useful in women <40 years old and was moderately useful in women >40 years old. (C) 2015 Canadian Diabetes Association