Community screening for pre-diabetes and diabetes using HbA1c levels in high-risk African Americans and Latinos

Ethn Dis. 2014 Spring;24(2):195-9.

Abstract

Objective: To evaluate community screening using HbA1c levels in high risk African Americans and Latinos in those not known to have diabetes.

Design: HbA1c levels were measured in 1542 African Americans and Latinos aged > or = 40 years with one or more of the following risk factors: family history in first degree relatives, waist circumference > or = 40 inches in males or > or = 35 inches in females, and hypertension, either treatment for or a measured BP of > or = 140/ 90 mm Hg. Oral glucose tolerance tests (OGTT) were offered to those meeting the HbA1c criterion for pre-diabetes.

Setting: Churches, community health fares, senior citizen sites.

Participants: People without known diabetes.

Main outcome measures: Proportion of people meeting the HbA1c criteria for prediabetes (5.8-6.4%) and diabetes (> or = 6.5%).

Results: 32% had one, 50% had two and 18% had three risk factors. By HbA1c criteria, 40% had pre-diabetes and 25% had diabetes. Increased waist circumference was the most common risk factor followed by a positive family history, and lastly, hypertension. Each individual risk factor was significantly (P < .001) and progressively more common as glycemia increased. Each additional risk factor increased the odds of pre-diabetes or diabetes by 2- to 4-fold. In individuals with pre-diabetes who underwent an OGTT, 59% were normal, 35% had pre-diabetes and only 6% had diabetes.

Conclusions: Community screening of high risk African Americans and Latinos with HbA1c levels identifies a large proportion of people with pre-diabetes and diabetes. Those identified with pre-diabetes are unlikely to meet the OGTT criteria for diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Black or African American / statistics & numerical data*
  • Community Health Services
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / ethnology
  • Female
  • Glycated Hemoglobin / metabolism
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Hypertension
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Prediabetic State / blood
  • Prediabetic State / diagnosis*
  • Prediabetic State / epidemiology
  • Prediabetic State / ethnology
  • Risk Factors
  • United States / epidemiology
  • Waist Circumference

Substances

  • Glycated Hemoglobin A