FINDRISK – ein praktisches Screeninginstrument für Diabetesrisiko – Evaluiert und einsatzbereit in Deutschland

Abteilung Prävention und Versorgung des Diabetes, Medizinische Klinik III, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden

Bis ein Diabetes Typ 2 diagnostiziert wird, hat ein Patient mitunter auch heute noch bereits mehr als 10 Jahre Hyperglykämie hinter sich. Bei der Entwicklung von individualisierten Diseasemanagement-Programmen beim Diabetes mellitus sind wir noch immer auf der Suche nach einfachen nicht invasiven Methoden, um Personen mit einem Erkrankungsrisiko zu identifizieren [1]. Neben den Eigenschaften valide, sicher, schnell und kosteneffektiv sollte eine Methode zur Feststellung des individuellen Diabetesrisikos auch reproduzierbar sein und eine wissenschaftlich evidente Risikostratifizierung erlauben [2] [3]. Dabei ist Letzteres bei diabetesgefährdeten Menschen gar nicht so einfach. In welchem Zusammenspiel oder mit welcher pathophysiologischen Grundlage und mit welcher Wichtung verschiedene Faktoren das Diabetesrisiko beeinflussen, ist schwierig zu beantworten, aber für unsere tägliche klinische Arbeit sehr wichtig. Zu Zeiten der evidenzbasierten Medizin ist es daher von großer Bedeutung, diese Konstellation von Risikofaktoren sowohl in Abhängigkeit von möglichen genetischen Dispositionen [4], medizinisch messbaren Parametern, als auch unter Verhaltensaspekten nachvollziehbar zu diagnostizieren.

Until definite diagnostic confirmation of a type 2 diabetes, a patient may have already been diagnosed for more than ten years as suffering from hyperglycaemia – a fact likely to occur even today. While we are still engaged in developing individualised disease management programs for diabetes mellitus patients, we are still on the track of simple non-invasive methods enabling us to identify persons who may be subject to risk. A method for establishing an individual diabetes mellitus risk must not only be valid, safe, rapid and cost-effective, it must also be reproducible and enable a scientifically evident risk stratification. This last-named condition is far from easy as far as diabetic risk persons are concerned. It is difficult to pin down, albeit highly essential to know for our daily clinical work, how the diabetes risk is mutually influenced, on which pathophysiological basis, and with which clinical importance of various factors.

Now that medicine has become evidence-based, it is of paramount importance to realise, reconstruct and diagnose this established constellation of risk factors both in relation to possibly genetically determined dispositions and medically assessable parameters, as well as under behavioral aspects.

Key words

FINDRISK - screening - Diabetes mellitus - identification - diabetes risk - method - risk stratification

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