Use of HbA1c in Screening for Cuban‐Americans with Undiagnosed Type 2 Diabetes

Abstract

The study evaluated the use of HbA1c as a screening tool for undiagnosed type 2 diabetes (fasting plasma glucose > 7.0 mmol/l) in a sample of Cuban‐Americans. Subjects were randomly recruited from Miami‐Dade and Broward counties, FL. Fasting plasma glucose (FPG) was measured by hexokinase enzymatic method. HbA1c was measured by the DCA2000+ system using the monoclonal antibody method. HbA1c demonstrated a high predictive value in detecting undiagnosed diabetes. The area under the receiver operating characteristics (ROC) curve was 0.87. Additionally, HbA1c had high sensitivity and specificity when using a cut off value of 6.37(%) (71% and 86% respectively). Moderate sensitivity and very high specificity were shown with a cut off value of 6.84 (57% and 96% respectively). In addition, the mean HbA1c for subjects with normal FPG (<6.1) was 5.9 ± 0.47 which is higher than the mean HbA1c reported in The National Health and Nutrition Examination Survey (NHANES) for other ethnic groups. HbA1c is a reliable alternative to FPG in screening for undiagnosed diabetes in Cuban‐Americans. An HbA1c cut off value of 6.37 shows high sensitivity and specificity for detecting subjects with undiagnosed diabetes in Cuban‐Americans. Supported by a grant from NIH/SCORE.