CORRELATION OF HEMOGLOBIN A1c AND DIABETES RISK USING THE THAI DIABETES RISK SCORE
Background: Early detection of diabetes allows prompt access to interventions that can improve microvascular and macrovascular disease outcomes. Multiple strategies have been employed, i.e., the use of diabetes risk scores including blood testing.
Objective: The study aimed to evaluate the correlation between point-of-care hemoglobin A1c (POC HbA1c) and Thai diabetes risk score.
Methods: A cross-sectional study was conducted consisting of 252 individuals without diabetes over the age of 35. Demographic data and anthropometric measures were recorded and the blood test for POC HbA1c including plasma glucose were performed.
Results: Of 252 participants, the mean HbA1c was 5.56 ± 0.73%, the median Thai diabetes risk score was 7 [5-10] and American Diabetes Association (ADA) risk score was 3 [2.3-4]. Males had higher risk scores than females. Weak positive correlations were observed between POC HbA1c and both Thai and ADA risk score (r = 0.226 and 0.279, respectively, p<0.001). The predictors of higher HbA1c among males were high BMI and waist circumference.
Conclusion: A weak correlation of POC HbA1c and Thai diabetes risk score suggested that POC HbA1c may not be beneficial in screening diabetes in out-of-clinic situations; however, male participants with WC >100 cm and BMI >27.5 kg/m2 were associated with highest HbA1c.
IDF Diabetes Atlas 9th Edition [Internet]. IDF. 2019. Available from: https://www.diabetesatlas.org/en/sections/worldwidetoll-of-diabetes.html.
IDF Diabetes Atlas [Internet]. IDF. 2019 [cited December 1, 2019]. Available from: https://diabetesatlas.org/data/en/country/196/th.html.
Beckman JA, Creager MA. Vascular complications of diabetes. Circulation Res 2016; 118: 1771-85.
Alva ML, Gray A, Mihaylova B, Leal J, Holman RR. The impact of diabetes-related complications onhealthcare costs: new results from the UKPDS (UKPDS 84). Diabet Med 2015; 32: 459-66.
Clinical Practice Guideline for Diabetes 2017 by Royal College of Physicians of Thailand, 3rd edition 2017.
Aekplakorn W, Bunnag P, Woodward M, Sritara P, Cheepudomwit S, Yamwong S, et al. A risk score for predicting incident diabetes in the Thai population. Diabetes Care 2006; 29: 1872-7.
Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020; 43 (Suppl 1): S14-s31.
Aekplakorn W, Tantayothai V, Numsangkul S, Sripho W, Tatsato N, Burapasiriwat T, et al. Detecting prediabetes and diabetes: Agreement between fasting plasma glucose and oral glucose tolerance test in Thai adults. J Diabetes Res 2015; 2015: 396505.
Kaur J, Jiang C, Liu G. Different strategies for detection of HbA1c emphasizing on biosensors and point-of-care analyzers. Biosens Bio electron 2019; 123: 85-100.
Campbell L, Pepper T, Shipman K. HbA1c: a review of non-glycaemic variables. J Clin Path 2019; 72: 12-9.
Penttila I, Penttila K, Holm P, Laitinen H, Ranta P, Torronen J, et al. Methods, units and quality requirements for the analysis of haemoglobin A1c in diabetes mellitus. World J Method 2016; 6: 133-42.
Weykamp C. HbA1c: a review of analytical and clinical aspects. Annals Lab Med 2013 ; 33: 393-400.
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Practice 2019; 157: 107843.
Thewjitcharoen Y, Jones EA, Butadej S, Nakasatien S, Chotwanvirat P, Wanothayaroj E, et al. Performanceof HbA1c versus oral glucose tolerance test (OGTT) as a screening tool to diagnose dysglycemic status in high-risk Thai patients. BMC Endocr Disord 2019; 19: 23.
Gray BJ, Bracken RM, Turner D, Morgan K, Thomas M, Williams SP, et al. Examining the relationship between HbA1c and diabetes risk models in a European population indicates a lower threshold to identify ‘high risk’ is required. Diabetes Vasc Dis Res 2016; 13: 228-35.
Marley JV, Oh MS, Hadgraft N, Singleton S, Isaacs K, Atkinson D. Cross-sectional comparison of point-of-care with laboratory HbA(1)c in detecting diabetes in real-world remote Aboriginal settings. BMJ Open 2015: 5: e006277.
Sobolesky PM, Smith BE, Saenger AK, Schulz K, Apple FS, Scott MG, et al. Multicenter assessment of a hemoglobin A1c point-of-care device for diagnosis of diabetes mellitus. Clin Biochem 2018; 61: 18-22.
Fellows SE, Cipriano GC. Variation between point-of-care and laboratory HbA1c testing in clinical practice. P R Health Sci J 2019; 38: 189-191.
Schnell O, Crocker JB, Weng J. Impact of HbA1c testing at point of care on diabetes management. J Diabetes Sci Tech 2017; 11: 611-7.
Whitley HP, Hanson C, Parton JM. Systematic diabetes screening using point-of-care HbA1c testing facilitates identification of prediabetes. Annals Fam Med 2017; 15: 162-4.
Tantipoj C, Sakoolnamarka SS, Supa-amornkul S, Lohsoonthorn V, Deerochanawong C, Khovidhunkit SP, et al. Screening for type 2 diabetes using point-of-care testing for HbA1c among Thai dental patients. Southeast Asian J Trop Med Pub Health 2017; 48: 455-65.
Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Preformance of point-of-care testing compared with the standard laboratory diagnostic test in the measurement of HbA1c in Indonesian diabetic and nondiabetic subjects. J Diabetes Res 2020; 2020: 2037565.
Bays HE, Chapman RH, Grandy S. The relationship of body mass index to diabetes mellitus, hypertensionand dyslipidaemia: comparison of data from two national surveys. Inter J Clin Prac 2007; 61: 737-47.
Copyright (c) 2021 Journal of Southeast Asian Medical Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal of Southeast Asian Medical Research will hold the copyright to all published articles. Copyright forms are handled by the publisher’s production department once a manuscript is accepted and scheduled for publication.