HbA1c Predicts Risk for T2D in African American, White Patients

Glycosylated hemoglobin (HbA_1c) measurements in combination with fasting laboratory tests and clinic data provide useful prediction for type 2 diabetes risk, according to a prospective analysis published in Diabetes Care.

In this prospective study, investigators included white (n = 11,244) and black (n = 2294) patients without diabetes who were participants in the Framingham Heart Study and Atherosclerosis Risk in Communities study. The investigators sought to determine whether HbA_1c was associated with a diabetes risk in the scenarios where HbA_1c, clinic data, fasting laboratory tests, or clinic data and fasting laboratory test data were available.

A total of 3315 patients included in this cohort developed type 2 diabetes over the course of 20 years. For each percentage unit HbA_1c increase, the odds of type 2 diabetes increased 2.7- to 4.5-fold (odds ratio [OR], 4.50; 95% CI, 3.35-6.03) in both white and black participants.

In white participants, the use of HbA_1c only, as well as HbA_1c in addition to clinic data, provided improved predictive value for type 2 diabetes (P <.05). Overall, the data demonstrated that HbA_1c, in addition to other available clinical data, is a useful tool for identifying patients at risk for diabetes.

This study included a small sample size and a limited range of ethnicities. Therefore, the findings cannot be generalized across the entire population. In addition, this study did not determine whether HbA_1c is useful for predicting diabetes risk in older individuals.

According to the findings, HbA_1c is a useful prognostic indicator for type 2 diabetes risk and “has a central place in [type 2 diabetes] prevention efforts” and in “identifying high-risk individuals so that preventive measures can be targeted at those who may need them the most.”

Reference

Leong A, Daya N, Porneala B, et al. Prediction of type 2 diabetes by hemoglobin A_1c in two community-based cohorts [published online October 26, 2017]. Diabetes Care. doi: 10.2337/dc17-0607