Hemoglobin A1C Criterion for Diabetes Diagnosis Among Hispanic and Non-Hispanic Populations

Getaneh, Asqual; Andrés, Raquel; Brillon, David J.; Findley, Sally E.

doi:10.4158/ep10119.or

Cited by 13 publications

(15 citation statements)

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“…The small but residual difference that set Mexicans apart from Puerto Ricans and Dominicans, and the variable divergence from non-Hispanic white participants in achieving glucose control is consistent with accumulating evidence that the Hispanic population in the United States is heterogeneous in cardiovascular risks, 5 in levels of glycated hemoglobin values, 21,22 and health behavior. 8 Insulin therapy at baseline reflecting a progressive decline of beta cell function, 23 was significantly linked with poorer *Glycated hemoglobin goal refers to <6.5 for the intensive arm and 7-7.9, inclusive, for the standard arm † Ever had a measured hemoglobin of >6.5/>7.9 among those who first achieved goal in their respective treatment arms ‡ Time to first glycated hemoglobin goal achievement; if <6.5/<7.9 at baseline, time to achievement = 0 days and cultural competence beyond language-consonance between clinical staff and study participants 8,25 were not the focus of the ACCORD trial and detailed measures were not collected.…”

Section: Discussionsupporting

confidence: 76%

Diabetes Control Among Hispanics in the Action to Control Cardiovascular Risk in Diabetes Trial

et al. 2012

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Section: Discussionsupporting

confidence: 76%

Diabetes Control Among Hispanics in the Action to Control Cardiovascular Risk in Diabetes Trial

et al. 2012

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“…As a more convenient screening method than FPG and OGTT, HbA1c test does not require fasting and is not influenced by the day to day variation. HbA1c has also been found to have a very high specificity in identifying diabetic patients in different racial/ethnic groups [46], [47]. Thus, including HbA1c as diagnosis criteria for both diabetes and prediabetes leads to reducing the false negative results in our study.…”

Section: Discussionmentioning

confidence: 55%

Evaluation of Finnish Diabetes Risk Score in Screening Undiagnosed Diabetes and Prediabetes among U.S. Adults by Gender and Race: NHANES 1999-2010

Zhang

et al. 2014

PLoS ONE

108

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ObjectiveTo evaluate the performance of Finnish Diabetes Risk Score (FINDRISC) in detecting undiagnosed diabetes and prediabetes among U.S. adults by gender and race.MethodsThis cross-sectional analysis included participants (aged ≥20 years) from the National Health and Nutrition Examination Survey (NHANES) 1999–2010. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve and the optimal cutoff points for identifying undiagnosed diabetes and prediabetes were calculated for FINDRISC by gender and race/ethnicity.ResultsAmong the 20,633 adults (≥20 years), 49.8% were women and 53.0% were non-Hispanic White. The prevalence of undiagnosed diabetes and prediabetes was 4.1% and 35.6%, respectively. FINDRISC was positively associated with the prevalence of diabetes (OR = 1.48 for 1 unit increase, p<0.001) and prediabetes (OR = 1.15 for 1 unit increase, p<0.001). The area under ROC for detecting undiagnosed diabetes was 0.75 for total population, 0.74 for men and 0.78 for women (p = 0.04); 0.76 for White, 0.76 for Black and 0.72 for Hispanics (p = 0.03 for White vs. Hispanics). The area under ROC for detecting prediabetes was 0.67 for total population, 0.66 for men and 0.70 for women (p<0.001); 0.68 for White, 0.67 for Black and 0.65 for Hispanics (p<0.001 for White vs. Hispanics). The optimal cutoff point was 10 (sensitivity = 0.75) for men and 12 (sensitivity = 0.72) for women for detecting undiagnosed diabetes; 9 (sensitivity = 0.61) for men and 10 (sensitivity = 0.69) for women for detecting prediabetes.ConclusionsFINDRISC is a simple and non-invasive screening tool to identify individuals at high risk for diabetes in the U.S. adults.

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“…Prior studies have suggested and demonstrated that HbA 1c may vary across racial/ethnic groups after adjustment for plasma glucose levels (5–12). In individuals without diabetes, two analyses based on the National Health Nutrition and Examination Survey (NHANES) have reported higher HbA 1c levels among African Americans and Mexican Americans compared with non-Hispanic whites, and these differences persisted after adjustment for age, sex, and anthropometric, biological, or other covariates (7,8).…”

Section: Introductionmentioning

confidence: 99%

“…Considering the diverse genetic admixture and socioeconomic, cultural, geographic, history, and migration patterns that characterize each U.S. Hispanic/Latino group, it cannot be assumed that the previously reported differences in HbA 1c compared with non-Hispanic whites apply to all heritage groups. One study suggested that HbA 1c may differ between Dominicans and other Hispanics/Latinos with diabetes (heritage groups not specified) (12). However, it is unknown whether this difference is also observed among other Hispanic/Latino heritage groups—independent of glycemic status—and what factors may explain those differences.…”

Section: Introductionmentioning

confidence: 99%

Differences in Hemoglobin A1c Between Hispanics/Latinos and Non-Hispanic Whites: An Analysis of the Hispanic Community Health Study/Study of Latinos and the 2007–2012 National Health and Nutrition Examination Survey

et al. 2016

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OBJECTIVETo determine whether, after adjustment for glycemia and other selected covariates, hemoglobin A1c (HbA1c) differed among adults from six Hispanic/Latino heritage groups (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) and between Hispanic/Latino and non-Hispanic white adults without self-reported diabetes.RESEARCH DESIGN AND METHODSWe performed a cross-sectional analysis of data from 13,083 individuals without self-reported diabetes from six Hispanic/Latino heritage groups, enrolled from 2008 to 2011 in the Hispanic Community Health Study/Study of Latinos, and 2,242 non-Hispanic white adults enrolled during the 2007–2012 cycles of the National Health and Nutrition Examination Survey. We compared HbA1c levels among Hispanics/Latinos and between Hispanics/Latinos and non-Hispanic whites before and after adjustment for age, sex, fasting (FPG) and 2-h post–oral glucose tolerance test (2hPG) glucose, anthropometric measurements, and selected biochemical and hematologic variables and after stratification by diabetes status: unrecognized diabetes (FPG ≥7.1 mmol/L or 2hPG ≥11.2 mmol/L), prediabetes (FPG 5.6–7.0 mmol/L or 2hPG 7.8–11.1 mmol/L), and normal glucose tolerance (FPG <5.6 mmol/L and 2hPG <7.8 mmol/L).RESULTSAdjusted mean HbA1c differed significantly across all seven groups (P < 0.001). Non-Hispanic whites had significantly lower HbA1c (P < 0.05) than each individual Hispanic/Latino heritage group. Upon stratification by diabetes status, statistically significant differences (P < 0.001) in adjusted mean HbA1c persisted across all seven groups.CONCLUSIONSHbA1c differs among Hispanics/Latinos of diverse heritage groups and between non-Hispanic whites and Hispanics/Latinos after adjustment for glycemia and other covariates. The clinical significance of these differences is unknown.

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Hemoglobin A1C Criterion for Diabetes Diagnosis Among Hispanic and Non-Hispanic Populations

Cited by 13 publications

References 32 publications

Diabetes Control Among Hispanics in the Action to Control Cardiovascular Risk in Diabetes Trial

Diabetes Control Among Hispanics in the Action to Control Cardiovascular Risk in Diabetes Trial

Evaluation of Finnish Diabetes Risk Score in Screening Undiagnosed Diabetes and Prediabetes among U.S. Adults by Gender and Race: NHANES 1999-2010

Differences in Hemoglobin A1c Between Hispanics/Latinos and Non-Hispanic Whites: An Analysis of the Hispanic Community Health Study/Study of Latinos and the 2007–2012 National Health and Nutrition Examination Survey

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