title: Community screening for pre-diabetes and diabetes using HbA1c levels in high-risk African Americans and Latinos.
abstract: OBJECTIVE
  To evaluate community screening using HbA1c levels in high risk African Americans and Latinos in those not known to have diabetes.
  
  
  METHODS
  HbA1c levels were measured in 1542 African Americans and Latinos aged > or = 40 years with one or more of the following risk factors: family history in first degree relatives, waist circumference > or = 40 inches in males or > or = 35 inches in females, and hypertension, either treatment for or a measured BP of > or = 140/ 90 mm Hg. Oral glucose tolerance tests (OGTT) were offered to those meeting the HbA1c criterion for pre-diabetes.
  
  
  METHODS
  Churches, community health fares, senior citizen sites.
  
  
  METHODS
  People without known diabetes.
  
  
  METHODS
  Proportion of people meeting the HbA1c criteria for prediabetes (5.8-6.4%) and diabetes (> or = 6.5%).
  
  
  RESULTS
  32% had one, 50% had two and 18% had three risk factors. By HbA1c criteria, 40% had pre-diabetes and 25% had diabetes. Increased waist circumference was the most common risk factor followed by a positive family history, and lastly, hypertension. Each individual risk factor was significantly (P < .001) and progressively more common as glycemia increased. Each additional risk factor increased the odds of pre-diabetes or diabetes by 2- to 4-fold. In individuals with pre-diabetes who underwent an OGTT, 59% were normal, 35% had pre-diabetes and only 6% had diabetes.
  
  
  CONCLUSIONS
  Community screening of high risk African Americans and Latinos with HbA1c levels identifies a large proportion of people with pre-diabetes and diabetes. Those identified with pre-diabetes are unlikely to meet the OGTT criteria for diabetes.
authors.forename: Mayer B
authors.initials: MB
authors.lastname: Davidson
authors.forename: Petra
authors.initials: P
authors.lastname: Duran
authors.forename: Martin L
authors.initials: ML
authors.lastname: Lee
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D006442:Glycated Hemoglobin