Diabetes Risk Score Calculator (IDRS, ADA, FINDRISC)

About the Diabetes Risk Score Calculator (IDRS, ADA, FINDRISC)

Many people have type 2 diabetes or prediabetes for years without knowing. A risk score — a few questions about your age, body size, activity and family — shows whether a blood test is worth doing now. This calculator offers three validated scores:

• the Indian Diabetes Risk Score (MDRF-IDRS), developed in Chennai for Indian adults: four questions, 0–100 points;
• the ADA type 2 diabetes risk test, the American Diabetes Association’s questionnaire for US adults: seven questions, 5 or more points means increased risk;
• the Finnish Diabetes Risk Score (FINDRISC), which estimates your chance of developing type 2 diabetes in the next 10 years: eight questions, 0–26 points.

It then explains which test — fasting plasma glucose, HbA1c or an oral glucose tolerance test — to discuss with your doctor, with the thresholds of the ADA Standards of Care.

Common uses

• Deciding whether to ask for a diabetes blood test at your next check-up.
• Checking a parent’s or partner’s risk with them, in a few minutes, without any equipment but a tape measure.
• Comparing what different scores say for the same person.

Indian Diabetes Risk Score (MDRF-IDRS)

• Age: under 35 → 0 · 35–49 → 20 · 50 or over → 30
• Waist: women under 80 cm, men under 90 cm → 0 · women 80–89, men 90–99 → 10 · women 90 or more, men 100 or more → 20
• Physical activity: vigorous exercise or strenuous (manual) work → 0 · moderate → 10 · mild → 20 · no exercise and sedentary → 30
• Parents with diabetes: neither → 0 · one → 10 · both → 20

60 or more is high risk of having undiagnosed diabetes, 30–50 moderate and under 30 probably low. The score was built from the Chennai Urban Rural Epidemiology Study; at 60 or more it picked up about 73% of people with undiagnosed diabetes.

ADA type 2 diabetes risk test

• Age: under 40 → 0 · 40–49 → 1 · 50–59 → 2 · 60 or over → 3
• Man → 1 · woman with gestational diabetes in the past → 1
• Mother, father, sister or brother with diabetes → 1
• High blood pressure ever diagnosed → 1
• Not physically active → 1
• Weight: BMI 25 to under 30 → 1 · 30 to under 40 → 2 · 40 or more → 3

A total of 5 or more means an increased risk of having type 2 diabetes. The test is adapted from the score of Bang et al., developed on US national survey data (NHANES). The ADA added the gestational-diabetes question and counts a point for not being active, where the original score took a point off for being active, so the totals here are the ADA test’s and not on the original score’s scale.

Finnish Diabetes Risk Score (FINDRISC)

• Age: under 45 → 0 · 45–54 → 2 · 55–64 → 3 · over 64 → 4
• BMI: under 25 → 0 · 25–30 → 1 · over 30 → 3
• Waist: men under 94 cm, women under 80 → 0 · men 94–102, women 80–88 → 3 · men over 102, women over 88 → 4
• At least 30 minutes of physical activity daily: no → 2
• Vegetables, fruit or berries every day: no → 1
• Ever taken blood-pressure medicine regularly → 2
• Ever found to have high blood glucose (health check, illness, pregnancy) → 5
• Diabetes in the family: grandparent, aunt, uncle or first cousin → 3 · parent, brother, sister or own child → 5

Risk of type 2 diabetes within 10 years: under 7 low (about 1 in 100) · 7–11 slightly elevated (1 in 25) · 12–14 moderate (1 in 6) · 15–20 high (1 in 3) · over 20 very high (1 in 2). The original Finnish score had seven questions (0–20 points); the questionnaire in use adds the family question.

Which blood test, and what the results mean

The ADA Standards of Care accept three tests for screening adults without symptoms:

• Fasting plasma glucose (no food or caloric drinks for at least 8 hours): normal below 100 mg/dL (5.6 mmol/L), prediabetes 100–125 mg/dL (5.6–6.9 mmol/L), diabetes 126 mg/dL (7.0 mmol/L) or more
• HbA1c (no fasting needed): normal below 5.7%, prediabetes 5.7–6.4% (39–47 mmol/mol), diabetes 6.5% (48 mmol/mol) or more. It can mislead with some haemoglobin variants, anaemia or recent blood loss, kidney failure, HIV and in pregnancy — then glucose tests are used
• Oral glucose tolerance test (a 75 g glucose drink, blood taken 2 hours later): normal below 140 mg/dL (7.8 mmol/L), prediabetes 140–199 mg/dL (7.8–11.0 mmol/L), diabetes 200 mg/dL (11.1 mmol/L) or more. It is the most sensitive of the three

Without symptoms, a result in the diabetes range is confirmed with a second test. With classic symptoms — heavy thirst, passing a lot of urine, unexplained weight loss — a random glucose of 200 mg/dL (11.1 mmol/L) or more is enough: see a doctor promptly, do not wait for a score.

When the ADA advises testing

• Everyone from age 35; if the result is normal, again at least every 3 years.
• At any age with overweight or obesity — BMI 25 or more, or 23 or more with Asian ancestry — plus at least one risk factor: a parent, brother or sister with diabetes; African American, Latino, Native American or Asian American ancestry; high blood pressure; HDL below 35 mg/dL or triglycerides above 250 mg/dL; polycystic ovary syndrome; physical inactivity; heart disease; or other signs of insulin resistance.
• After gestational diabetes: at least every 1–3 years. With prediabetes: every year.

Sources

• Mohan V et al. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India
• Deepa M et al. Evaluation of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score in the Indian population — the current MDRF-IDRS table
• Bang H et al. Development and validation of a patient self-assessment score for diabetes risk. Ann Intern Med
• American Diabetes Association type 2 diabetes risk test
• Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care
• American Diabetes Association. Diagnosis and classification of diabetes: Standards of Care in Diabetes, section 2

Limitations

• A risk score is not a diagnosis. Only a blood test can show diabetes or prediabetes, and a low score does not rule them out.
• Each score was built in one population: IDRS in Chennai (India), the ADA test on US survey data, FINDRISC in Finland. They may work less well in other groups and in young adults.
• These scores are for type 2 diabetes in adults. They do not apply to type 1 diabetes, children or pregnancy.
• If you already know you have diabetes, these scores do not apply — talk to your care team instead.

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