Skip to main content
SpringerLink
Log in

Use of HbA1c in Screening for Cuban-Americans with Undiagnosed Type 2 Diabetes

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

This study evaluated the use of HbA1c as a screening tool for undiagnosed type 2 diabetes (fasting plasma glucose ≥7.0 mmol/l) in a sample of Cuban-Americans aged ≥ 30 years old. Subjects were randomly recruited from Miami-Dade and Broward counties, FL. Fasting plasma glucose was measured by hexokinase enzymatic method. HbA1c was measured by the DCA2000 + system using the monoclonal antibody method. HbA1c demonstrated a high predictive value in detecting undiagnosed diabetes. The area under the receiver operating characteristics (ROC) curve was 0.87. Also, HbA1c had high sensitivity and specificity when using a cut off value of 6.37 (71 and 86%, respectively). Moderate sensitivity and very high specificity were shown with a cut off value of 6.84 (57 and 96%, respectively). HbA1c is a reliable alternative to fasting plasma glucose in screening for undiagnosed diabetes in Cuban-Americans.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. World Health Organization. Diabetes Mellitus: Report of a WHO Study Group Geneva. Tech Rep Ser No. 727;1985.

  2. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(1):S5–S20.

    Google Scholar 

  3. Rohlfing CL, Little RR, Wiedmeyer HM, England JD, Madsen R, Harris M, et al. Use of GHb (HbA1c) in screening for undiagnosed diabetes in the US population. Diabetes Care. 2000;23(2):187–91.

    Article  PubMed  CAS  Google Scholar 

  4. Modan M, Halkin H, Karasik A, Lusky A. Effectiveness of glycosylated hemoglobin, fasting plasma glucose, and a single post load plasma glucose level in population screening for glucose intolerance. Am J Epidemiol. 1984;119:431–44.

    PubMed  CAS  Google Scholar 

  5. Guillausseau PJ, Charles MA, Paolaggi F, Timsit J, Chanson P, Peynet J, Godard V, Eschwege E, Rousselet F, Lubetzki J. Comparison of HbA1c and fructosamine in diagnosis of glucose-tolerance abnormalities. Diabetes Care. 1990;13:898–900.

    Article  PubMed  CAS  Google Scholar 

  6. Gerken KL, Van Lente F. Effectiveness of screening for diabetes. Arch Pathol Lab Med. 1990;114:201–3.

    PubMed  CAS  Google Scholar 

  7. Mulkerin EC, Arnold JD, Dewar R, Sykes D, Rees A, Pathy MSJ. Glycosylated hemoglobin in the diagnosis of diabetes mellitus in elderly people. Age Ageing. 1992;21:175–7.

    Article  Google Scholar 

  8. Kilpatrick ES, Maylor PW, Keevil BG. Biological variation of glycated hemoglobin: implications for diabetes screening and monitoring. Diabetes Care. 1998;21:261–4.

    Article  PubMed  CAS  Google Scholar 

  9. Edelman D, Olsen MK, Dudley TK, Harris AC, Oddone EZ. Utility of hemoglobin A1c in predicting diabetes risk. J Gen Intern Med. 2004;19:1175–80.

    Article  PubMed  Google Scholar 

  10. Selvin E, Zhu H, Brancati FL. Elevated A1c in adults without a history of diabetes in the US. Diabetes Care. 2009;32(5):828–33.

    Article  PubMed  Google Scholar 

  11. Ko GTC, Chan JCN, Tsang LWW, Cockram CS. Combined use of fasting plasma glucose and HbA1c predicts the progression to diabetes in Chinese subjects. Diabetes Care. 2000;23:1770–3.

    Article  PubMed  CAS  Google Scholar 

  12. Pradhan AD, Rifai N, Buring JE, Ridker PM. Hemoglobin A1c predicts diabetes but not cardiovascular disease in nondiabetic women. Am J Med. 2007;120:720–7.

    Article  PubMed  CAS  Google Scholar 

  13. Droumaguet C, Balkau B, Simon D, Caces E, Tichet J, Charles MA. Eschwege E: the DESIR study group. Use of HbA1c in predicting progression to diabetes in French men and women: data from an epidemiological study on the insulin resistance syndrome (DESIR). Diabetes Care. 2006;29:1619–25.

    Article  PubMed  CAS  Google Scholar 

  14. Inoue K, Matsumoto M, Kobayashi Y. The combination of fasting plasma glucose and glycosylated hemoglobin predicts type 2 diabetes in Japanese workers. Diabetes Res Clin Pract. 2007;77:451–8.

    Article  PubMed  CAS  Google Scholar 

  15. Saudek CD, Herman WH, Sacks DB, Bergenstal RM, Edelman D, Davidson MB. A new look at screening and diagnosing diabetes mellitus. Clin Endocrinol Metab. 2008;93:2447–53.

    Article  CAS  Google Scholar 

  16. Flegal KM, Ezzati TM, Harris MI, Haynes SG, Juarez RZ, Knowler WC, et al. Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982–1984. Diabetes Care. 1991;14(7):628–38.

    Article  PubMed  CAS  Google Scholar 

  17. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4–7 year before clinical diagnosis. Diabetes Care. 1992;15:815–9.

    Article  PubMed  CAS  Google Scholar 

  18. Harris MI. Undiagnosed NIDDM: clinical and public health issues. Diabetes Care. 1993;16:642–52.

    PubMed  CAS  Google Scholar 

  19. US Census Bureau. Current Population Survey, March 2002, PGP-5. Washington, DC: US Census Bureau, March 2002.

  20. Huffman FG, Knight-Sepulveda K, Mclean M, Zarini GG. Increased adiponectin among Cuban American type 2 diabetics with metabolic syndrome. FASEB J. 2009;23:547.8.

    Google Scholar 

  21. Huffman FG, Gomez GP, Zarini GG. Metabolic syndrome and high-sensitivity C-reactive protein in Cubans. Ethn Dis. 2009;19(2):115–20.

    PubMed  Google Scholar 

  22. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2008;31:S55–S60.

    Article  Google Scholar 

  23. American Diabetesc Association. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20:1183–97.

    Google Scholar 

  24. Beck JR, Shultz EK. The use of relative operating characteristic (ROC) curves in test performance evaluation. Arch Pathol Lab Med. 1986;110:13–20.

    PubMed  CAS  Google Scholar 

  25. Little RR. Glycated hemoglobin standardization–National Glycohemoglobin Standardization Program (NGSP) perspective. Clin Chem Lab Med. 2003;41(9):1191–8.

    Article  PubMed  CAS  Google Scholar 

  26. Voss EM, Cembrowski GS, Clasen BL, Spencer ML, Ainslie MB, Haig B. Evaluation of capillary collection system for HbA1c specimens. Diabetes Care. 1992;15:700–1.

    Article  PubMed  CAS  Google Scholar 

  27. Selvin E, Crainiceanu CM, Brancati FL, Coresh J. Short-term variability in measures of glycemia and implications for the classification of diabetes. Arch Intern Med. 2007;167:1545–51.

    Article  PubMed  CAS  Google Scholar 

  28. PEW Hispanic Center. Fact Sheet: Cubans in the United States. August 25, 2006. 1615 L Street, NW, Suite 700, Washington, DC 20036-5610. Available online: http://pewhispanic.org/files/factsheets/23.pdf.

Download references

Acknowledgments

This research was funded by a grant from NIH/MBRS/SCORE-AC#124401529/42.

Author information

Authors and Affiliations

  1. Department of Dietetics and Nutrition, Florida International University, 11200 SW 8th ST, HLS I-450, Miami, FL, 33199, USA

    Fatma G. Huffman, Joel C. Exebio & Gustavo G. Zarini

  2. Universidad Privada Antenor Orrego, Av. América Sur 3145 Monserrate, Apartado Postal 1075, Trujillo, Peru

    Cristobal Exebio

Authors
  1. Fatma G. Huffman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joel C. Exebio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gustavo G. Zarini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cristobal Exebio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fatma G. Huffman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huffman, F.G., Exebio, J.C., Zarini, G.G. et al. Use of HbA1c in Screening for Cuban-Americans with Undiagnosed Type 2 Diabetes. J Immigrant Minority Health 13, 541–545 (2011). https://doi.org/10.1007/s10903-010-9363-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-010-9363-3

Keywords

Search

Navigation