A new screening method uses an unexpected body measurement to estimate diabetes risk without a blood test.
Researchers have developed a free online screening tool that considers the length of a person’s thigh alongside six more familiar health indicators. Called MEDWACS, the tool estimates the likelihood that an adult has prediabetes or undiagnosed type 2 diabetes without requiring laboratory testing.
The unusual approach could help address a major blind spot in public health. About 115.2 million US adults have prediabetes, and roughly eight in 10 do not know it, according to the Centers for Disease Control and Prevention. Prediabetes often causes no clear symptoms, yet it raises the risk of developing type 2 diabetes, heart disease, and stroke.
“Type 2 diabetes is easy to diagnose with a blood test, but if you don’t suspect you have it, you won’t go to the doctor to have one done. That’s why an online test at home can encourage people to see a doctor,” said Daniel Yoo, a postdoctoral researcher at DTU Sustain who led the project.
The Research Team Behind MEDWACS
Yoo created MEDWACS with DTU Professor Olivier Jolliet and Umberto Maggiore, an Italian physician and researcher at the University of Parma who specializes in kidney disease. Diabetes can damage the kidneys when elevated blood sugar harms their filtering system over time.
Their peer-reviewed study was published in the Journal of Clinical Epidemiology.
How the MEDWACS Test Works
To use MEDWACS, adults enter seven pieces of information:
Age, sex, body mass index, waist circumference, systolic blood pressure, upper arm circumference, and thigh length.
The measurements can be collected at home with a tape measure, bathroom scale, and standard blood pressure monitor. The researchers selected these seven factors from nearly 3,700 candidates analyzed by a machine learning system.
Testing the Diabetes Risk Model
The model was developed using 30 years of data from the National Health and Nutrition Examination Survey, a major US health research program. It included adults of both sexes beginning at age 18.
The team then evaluated the model using separate datasets from the United States and South Korea. Because researchers already knew which participants had prediabetes or diabetes, they could compare the tool’s predictions with confirmed health outcomes.
In both external validations, MEDWACS performed as well as or better than other established risk assessment methods, according to the study. The researchers concluded that it could offer an accessible way to identify people who should seek clinical testing.
Why Thigh Length May Predict Diabetes Risk
Among the seven factors, thigh length is easily the most unexpected. Even the researchers were initially surprised that it carried useful information.
Maggiore said the measurement may capture two different influences on diabetes risk: childhood development and adult muscle mass.
“The length of the femur bears witness to nutrition in early childhood. Poor nutrition in the first years of life slightly inhibits bone growth and is closely linked to an increased risk of diabetes decades later. Furthermore, the body’s largest muscle group is also located in the thighs, and these muscles are responsible for removing sugar from the blood. Overall, shorter legs mean that a person has less muscle mass to absorb that sugar, which increases the risk of diabetes.”
Skeletal muscle removes much of the glucose circulating in the bloodstream by taking it in for energy or storage. Having less muscle mass may therefore reduce the body’s ability to clear glucose.
Reference: “Enhancing prediabetes and diabetes detection through a machine learning-enabled self-assessment approach” by Daniel Yoo, Umberto Maggiore and Olivier Jolliet, 6 April 2026, Journal of Clinical Epidemiology.
DOI: 10.1016/j.jclinepi.2026.112266
This project was funded by the Novo Nordisk Foundation.
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