Diabetes can be detected using glycated haemoglobin

January 01, 0001

Diabetes can be detected using glycated haemoglobin

The aim of this study by researchers from Australia and Saudi Arabia was to assess the utility of glycated haemoglobin (HbA1c) level as an automated screening test for undiagnosed diabetes among hospitalised patients and to estimate the prevalence of undiagnosed diabetes among hospitalised patients. A 3-month prospective study of all adult patients admitted to a tertiary hospital. An HbA1c test was automatically undertaken on admission for all patients with a random plasma glucose (RPG) level greater than or equal to 5.5 mmol/L. Demographic, admission and biochemical data were obtained from hospital databases. A subset of patients was recruited for an oral glucose tolerance test (OGTT) after discharge.

The prevalence of undiagnosed diabetes was 11% during the study period. A further 312 patients with known diabetes were admitted. The prevalence of undiagnosed diabetes was highest in the 65-74-years age group. The HbA1c test cost was $152 per new diagnosis of diabetes. Conservatively assuming an annual incidence of undiagnosed diabetes of 0.8%, the ongoing cost of testing hospitalised patients would be $2100 per new diagnosis of diabetes. RPG testing was not sensitive or specific in diagnosing diabetes. Patients were poorly compliant with the post-discharge OGTT (27% completion rate).

The researchers concluded: "HbA1c is a simple, inexpensive screening test that can be automated using existing clinical blood samples. Hospital screening for diabetes needs to be coupled with resources for management in the community."

Although from a hospital setting, this can be important in general practice.

For the full abstract, click here.

MJA 194(4):160-164, 21 February 2011
© The Medical Journal of Australia 2011
Detecting undiagnosed diabetes using glycated haemoglobin: an automated screening test in hospitalised patients. Nyoli A Valentine, Tariq M Alhawassi, Greg W Roberts et al. Correspondence to Matthew Doogue: matt.doogue@health.sa.gov.au

Category: T. Endocrine/Metabolic/Nutritional Keywords: detecting, undiagnosed, diabetes, glycated haemoglobin, automated, screening, test, hospitalized, patients, prospective study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 11 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.