Development and validation of a new diabetes index for the risk classification of present and new-onset diabetes: multicohort study

Abstract In this study, we aimed to propose a novel diabetes index for the risk classification based on machine learning techniques with a high accuracy for diabetes mellitus. Upon analyzing their demographic and biochemical data, we classified the 2013–16 Korea National Health and Nutrition Examination Survey (KNHANES), the 2017–18 KNHANES, and the Korean Genome and Epidemiology Study (KoGES), as the derivation, internal validation, and external validation sets, respectively. We constructed a new diabetes index using logistic regression (LR) and calculated the probability of diabetes in the validation sets. We used the area under the receiver operating characteristic curve (AUROC) and Cox regression analysis to measure the performance of the internal and external validation sets, respectively. We constructed a gender-specific diabetes prediction model, having a resultant AUROC of 0.93 and 0.94 for men and women, respectively. Based on this probability, we classified participants into five groups and analyzed cumulative incidence from the KoGES dataset. Group 5 demonstrated significantly worse outcomes than those in other groups. Our novel model for predicting diabetes, based on two large-scale population-based cohort studies, showed high sensitivity and selectivity. Therefore, our diabetes index can be used to classify individuals at high risk of diabetes.