Aim: To evaluate the performance of FINDRISC as a screening tool for prediabetes impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and undetected diabetes (UDD) in subjects at risk of developing diabetes. Subjects and methods: 2169 subjects with at least one risk factor for diabetes completed the FINDRISC questionnaire and underwent an oral glucose tolerance test. FINDRISC performance was assessed using the area under the receiver operating characteristic curve (AUC-ROC). Results: 56.6% of subjects demonstrated normal glucose tolerance (NGT), 14.5% -IFG, 11.4% IGT and 17.5% -UDD. NGT group demonstrated mean FINDRISC 10.1 +/- 3.4, IFG group 13.8 +/- 4.3 (p < 0.0001 vs. NGT), IGT group -14.4 +/- 5.4 (p < 0.0001 vs. NGT) and UDD group 15.5 +/- 4.8 (p < 0.0001 vs. NGT and IFG, p < 0.01 vs. IGT). The AUC-ROC was 0.70 (95% CI 0.67-0.73) for UDD and 0.71 (95% CI 0.69-0.73) for undetected prediabetes and diabetes. The FINDRISC cut-off value of 10 to identify both prediabetes and diabetes had sensitivity of 84% and specificity of 61%. Conclusions: FINDRISC is a feasible, non-invasive and useful tool for identifying subjects at risk for undetected diabetes and prediabetes. Laboratory screening should be performed in subjects with FINDRISC higher than 10. (C) 2010 Elsevier Ireland Ltd. All rights reserved.