Elevated HbA1c levels in individuals not diagnosed with type 2 diabetes in Qatar: a pilot study.
BACKGROUND
The prevalence of type 2 diabetes (T2D) in Qatar and the Middle East is one of the highest in the world. It is estimated that about one quarter of the individuals with tbl2D are undiagnosed. Elevated HbA1c levels are an indicator of tbl2D or a pre-diabetic state. In this study we set out to examine which factors, such as anthropometric and socio-demographic risk factors, are associated with elevated HbA1c levels in a population without tbl2D.


METHODS
We examined 191 subjects with no record of tbl2D. Anthropometrics and HbA1c were measured. Socio-demographic (age, gender, ethnicity and educational level) and health information were assessed through questionnaires. Elevated HbA1c levels were defined as >6.0% (>42 mmol/mol). Individual risk factors were examined in relationship to having elevated HbA1c levels using logistic regression.


RESULTS
Thirty-eight (20%) study participants had elevated HbA1c levels. Participants from South Asian and Filipino descent were more likely to present with elevated HbA1c levels than Arab participants (adjusted odds ratios (OR): 13.30 (95% confidence interval (CI): 4.24, 41.79), p < 0.001 for South Asian and 4.54 (95% CI: 1.04, 19.83), p = 0.04 for Filipinos). A body mass index of above 30 kg/m(2) was associated with elevated HbA1c levels (adjusted OR: 2.90 (95% CI: 1.29, 6.51), p = 0.01). Neither gender nor educational level was associated with elevated HbA1c levels.


CONCLUSIONS
Elevated HbA1c levels in individuals not diagnosed with diabetes were most frequently found in the South Asian and Filipino immigrant population. Special attention should therefore be given to the early identification of tbl2D in these subjects.
Department of Physiology and Biophysics, Weill Cornell Medical College - Qatar, Doha, Qatar.
Marjonneke J
MJ
Mook-Kanamori
Dermatology Department, Hamad Medical Corporation, Doha, Qatar.
Mohammed M
MM
El-Din Selim
Dermatology Department, Hamad Medical Corporation, Doha, Qatar.
Ahmed H
AH
Takiddin
Dermatology Department, Hamad Medical Corporation, Doha, Qatar.
Khoulood A S
KA
Al-Mahmoud
Dermatology Department, Hamad Medical Corporation, Doha, Qatar.
Hala
H
Al-Homsi
Department of Clinical Research, Weill Cornell Medical College - Qatar, Doha, Qatar.
Cindy
C
McKeon
Department of Physiology and Biophysics, Weill Cornell Medical College - Qatar, Doha, Qatar.
Wadha A
WA
Al Muftah
Department of Physiology and Biophysics, Weill Cornell Medical College - Qatar, Doha, Qatar.
Sara Abdul
SA
Kader
Dennis O
DO
Mook-Kanamori
Karsten
K
Suhre
HbA1c; ethnic differences; pre-diabetes; public health; undiagnosed type 2 diabetes