2015-05-10

Improving the Undiagnosed Rate of Diabetes Mellitus Using a Point-of-Care A1C Device

Heather Whitley

Abstract

Aims. Todetermine the undiagnosed rate of diabetes and prediabetes in a high-risk rural population.Over 8% of the American population has diabetes mellitus. Portions of the country with the greatest prevalence include rural, underserved areas in the South. Despite its wide-spread prevalence 7 million are unknowingly living with the condition.Early detection allows for prevention of long-term disease complications. Methods. Patients at a rural family medicine clinic were prospectively pre-evaluatedaccording to the American Diabetes Association’s criteria. Eligible adults were offered a free point-of-care hemoglobin HbA1c screening. Results. Sixty-one percent (n=69) were unknowingly living with chronic hyperglycemia;50% (n=57) had an HbA1c between 5.7% and 6.4%. Average HbA1c values for patients with euglycemia, prediabetes, and diabetes were 5.34%, 5.91%, and 6.88%, respectively. Body mass index (p=0.001) and age (p=0.0003) were statistically significant contributors to HbA1c. Conclusion. Systematically screening asymptomatic adults for diabetes is important. Using a convenient point-of-careHbA1c device improved awareness, facilitated diagnosis, and further articulated the incidence of diabetes and prediabetes in a rural underserved population. In turn, early diagnosis and intervention allows patients to incorporate daily healthy behavioral strategies which can delay the diagnosis or slow the progress of diabetes and ultimately improve morbidity and mortality.

Keywords: diabetes mellitus, point-of-care, hemoglobin A1C, diagnosis, prediabetes, undiagnosed, incidence