PreDx Diabetes Risk Score (DRS)

What is the PreDx DRS?

Diabetes Risk Score

Your score and risk level appear on the colored scale of the PreDx DRS report that was sent to your physician.

PreDx DRS measures seven different biomarkers in your blood that are related to your risk for developing diabetes. These measurements are combined into a single, personalized risk score from 1 (lower) to 10 (highest) that tells you your level of risk for developing diabetes within the next five years.8


 

What does the PreDx DRS measure and what do the results mean?

Diabetes develops over many years in your body, causing damage as it progresses to a point where it can be diagnosed. However, this damage can be detected by measuring the levels of specific biomarkers in your blood—levels that will be either too high or too low in response to the damage occurring along different biological pathways linked to the development of diabetes.9 These are:

Blood Sugar Metabolism (Glucose)
All cells in your body need blood sugar (glucose) to function properly. In order to use glucose, your body needs insulin. Insulin is produced by the beta cells in the pancreas and helps keep the levels of glucose in your blood stable.This is called metabolic homeostasis. Changes in your fasting glucose levels reflect a change in metabolic homeostasis, and may indicate a problem with your pancreatic beta cells.

Hemoglobin A1c (HbA1c) reflects the amount of glucose in your blood over a three-month period of time. High levels of glucose, hemoglobin A1c, and insulin indicate an increased risk of diabetes.

Fat Cell Function (Adipose)
Adiponectin is a protein hormone that is released into the blood by fat cells (adipose tissue) in your body.

Inflammation/Atherosclerosis
Your immune system uses inflammation to repair cells after an injury or infection. In most cases, this response stops once the body is healed.

When inflammation continues for a long time (called chronic inflammation), it can put stress on certain organ systems, including the heart and the pancreas. High levels of inflammation for a long time in the body can lead to the development of diabetes.

PreDx Test Report

Once your blood test has been analyzed, your doctor will receive a report with the results. Here’s an example of what your PreDx DRS report will look like:

The PreDx Risk Assessment Score

Once your blood test has been analyzed, your doctor will receive a report with the results. Here’s an example of what your PreDx DRS report will look like. Click on the information icons to learn more.

Glucose Metabolism Biomarkers

Glucose is a simple sugar (a monosaccharide) that is essential for cellular function. Ordinarily, the level of glucose in the blood is maintained at a relatively stable concentration. Clinically detectable changes in fasting glucose levels suggest a change in metabolic homeostasis, and may reflect insulin resistance and insulin deficiency related to dysfunction of the pancreatic β-cells.43

Insulin is a hormone secreted by pancreatic β-cells that functions to maintain blood glucose levels within a very narrow concentration range.44 It has long been recognized that defects in both insulin action (sensitivity or resistance to insulin) and insulin secretion (β-cell dysfunction) play a pivotal role in the pathogenesis of diabetes.45-48 Insulin resistance occurs when pancreatic β-cells make enough insulin, but the cells of the body that normally respond to insulin by taking up glucose fail to respond properly.49 Defects in insulin secretion, on the other hand, occur when pancreatic β-cells fail to produce enough insulin to maintain blood glucose control.50

HbA1c (glycosylated hemoglobin A1c) is formed when glucose attaches to hemoglobin over the typical 120-day life span of a red blood cell. Formation of glycated proteins is proportional to the concentration of glucose in the blood. The test for hemoglobin A1c (HbA1c) measures the percentage of hemoglobin A1c that is attached to glucose. The amount of HbA1c circulating in the blood serves as an indicator of average blood glucose levels over the previous two to three months.51

Inflammation and Atherosclerosis Biomarkers

CRP (C-Reactive Protein) is a classical acute phase protein that serves as a non-specific marker of subclinical systemic inflammation.52 Several studies have found an association between circulating CRP levels and risk of type 2 diabetes.53-56 Although the biological mechanisms through which CRP increases diabetes risk remain speculative, its consistent correlation with development of type 2 diabetes renders CRP a useful marker in multivariate models of diabetes risk.

Ferritin is an intracellular iron binding protein, and its blood levels are associated with total body iron stores. Although ferritin is released into the blood during acute inflammatory response, persistently elevated levels of total body iron and plasma ferritin levels have been associated with insulin resistance, diabetes and diabetes risk.57,58 The network of interactions that links elevated iron stores with type 2 diabetes is uncertain, however, several possible mechanisms have been proposed. These include iron deposition in the liver which may cause insulin resistance by interfering with the ability of insulin to suppress hepatic glucose production; iron accumulation in hepatocytes which may also interfere with the insulin-extracting capacity of the liver and affect insulin synthesis and secretion in the pancreas; and oxidative stress caused by highly reactive iron-oxygen complexes that could lead to hyperglycemia through disturbed glucose metabolism.59

Interleukin 2 Receptor Alpha (IL-2Rα) is a soluble blood-borne fragment of the receptor for the pro-inflammatory protein interleukin-2. Increased concentrations of serum IL-2Rα have been found in subjects with autoimmune disease, inflammation and infection.60-62 While a few studies have noted an association between IL-2Rα and type 2 diabetes, the role of elevated serum IL-2Rα in type 2 diabetes remains uncertain.63,64 One hypothesis is that serum IL-2Rα indicates increased levels of activated T-cells resulting from the upregulation of inflammatory pathways.65 An increase in activated T lymphocytes in patients with type 2 diabetes has been reported in at least one study.66

Adipose Function Biomarkers

Adiponectin is a unique adipocyte-derived hormone that increases sensitivity to insulin and has anti-inflammatory and anti-atherogenic effects.67 Whereas high levels of adiponectin are typical of normal, healthy individuals, several studies have documented that reducedlevels of adiponectin are correlated with elevated risk for type 2 diabetes.68-75

Does a high-risk score mean you will get diabetes?

A High DRS indicates that your risk of developing type 2 diabetes is significantly greater than the general population. For example, if your DRS is 8.3, your risk of developing diabetes within the next 5 years is over four times greater than the average person. However, a High DRS does not mean conversion to diabetes is inevitable. Diabetes can be delayed and even prevented by making changes to your lifestyle that can significantly lower your risk.10

Does a low score mean you won’t get diabetes?

The PreDx DRS assesses your risk of developing type 2 diabetes within the next 5 years. A score in the low or moderate range does not mean that you will never get diabetes, it just means that your risk is not as imminent as individuals with a high score. To keep your risk of diabetes from increasing, you should develop healthy lifestyle habits – maintaining a healthy weight, exercising regularly, and following all your clinician’s recommendations.