Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study.

Prediction rules for type 2 diabetes mellitus (T2DM) have been developed, but we lack consensus for the most effective approach.

We estimated the 7-year risk of T2DM in middle-aged participants who had an oral glucose tolerance test at baseline. There were 160 cases of new T2DM, and regression models were used to predict new T2DM, starting with characteristics known to the subject (personal model, ie, age, sex, parental history of diabetes, and body mass index [calculated as the weight in kilograms divided by height in meters squared]), adding simple clinical measurements that included metabolic syndrome traits (simple clinical model), and, finally, assessing complex clinical models that included (1) 2-hour post-oral glucose tolerance test glucose, fasting insulin, and C-reactive protein levels; (2) the Gutt insulin sensitivity index; or (3) the homeostasis model insulin resistance and the homeostasis model insulin resistance beta-cell sensitivity indexes. Discrimination was assessed with area under the receiver operating characteristic curves (AROCs).