Haemoglobin A1c-based screening for prediabetes and diabetes mellitus: a multi-center study in Croatian adult population

Based on the hypothesis that there is a substantial rate of adults with prediabetes and undiagnosed diabetes mellitus (DM), our aim was to perform haemoglobin A1c (HbA )-based screening in a cohort of Croatian adults and estimate the prevalence of prediabetes and undiagnosed DM according to American...

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Published in:	Biochemia Medica Vol. 32; no. 1; pp. 010903 - 121
Main Authors:	Lapić, Ivana, Rogić, Dunja, Nikolac Gabaj, Nora, Kajić, Katarina, Peran, Nena, Surjan, Lada, Đuras, Anamarija, Cesar Kocijan, Valentina, Bilopavlović, Nada, Smaić, Fran, Štefanović, Mario, Ostroški, Ivanka, Tandara, Leida, Krnjaić-Tadijanović, Milena, Gornik, Ivan, Pintarić, Hrvoje, Marasović Krstulović, Daniela, Miškić, Blaženka, Rahelić, Dario
Format:	Journal Article Web Resource
Language:	English
Published:	Croatia Medicinska naklada 15-02-2022 Croatian Society of Medical Biochemistry and Laboratory Medicine
Subjects:	Adult Croatia - epidemiology Cross-Sectional Studies diabetes mellitus Diabetes Mellitus - diagnosis Diabetes Mellitus - epidemiology Female Glycated Hemoglobin A - analysis haemoglobin A1c Humans Male Mass Screening Middle Aged prediabetes Prediabetic State - diagnosis Prediabetic State - epidemiology prevalence Short Communications Croatia prevalence diabetes mellitus haemoglobin A1c prediabetes
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Summary:	Based on the hypothesis that there is a substantial rate of adults with prediabetes and undiagnosed diabetes mellitus (DM), our aim was to perform haemoglobin A1c (HbA )-based screening in a cohort of Croatian adults and estimate the prevalence of prediabetes and undiagnosed DM according to American Diabetes Association criteria. This multi-center, cross-sectional study performed in six Croatian hospitals included 5527 patients aged 40 to 70 years admitted to the Emergency Department or undergoing a primary care check-up. Haemoglobin A1c was measured from leftover whole blood samples using the enzymatic method on either Alinity c or Architect c-series analyser (Abbott Laboratories, Chicago, USA). Haemoglobin A1c between 39-47 mmol/mol was classified as prediabetes, while ≥ 48 mmol/mol as undiagnosed DM. After exclusion of 435 patients with known DM, the final cohort included 5092 patients (median age 57; 56% males). A total of 882 (17.3%) patients had HbA values between 39 and 47 mmol/mol. There were 214 (4.2%) patients with HbA ≥ 48 mmol/mol. Prediabetes prevalence ranged from 14.2% to 20.5%, while undiagnosed DM from 3.3% to 7.3%, with statistically significant differences among settings (P < 0.001). Age-stratified analysis showed that prediabetes and undiagnosed DM prevalence increase with age (P < 0.001), being 25.4% and 5.8%, respectively, in patients aged 60 to 70 years. Underlying impairment of glucose metabolism was identified in about one in five adults, with significant number of patients with already overt DM. These results should serve as a starting point for further steps directed towards promotion of preventive measures for DM in Croatia.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 269597
ISSN:	1330-0962 1846-7482
DOI:	10.11613/BM.2022.010903