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Screening life insurance applicants with hemoglobin A1c: a pilot study of cost-benefit
1Jackson National Life Insurance Company, 1 Corporate Way, Lansing, MI 48951, USA. clifford.hale@jnli.com
Insights
Hemoglobin A1c (HgbA1c) testing effectively detects carbohydrate intolerance and correlates with mortality risk. Despite higher costs, HgbA1c offers superior insights compared to other glucose tests for risk assessment.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Risk Assessment
Background:
- Diabetes mellitus is a growing global health concern.
- Obesity and aging populations increase diabetes prevalence.
- Carbohydrate intolerance is a key risk factor for mortality.
Purpose of the Study:
- To evaluate Hemoglobin A1c (HgbA1c) as a diagnostic tool for carbohydrate intolerance.
- To compare HgbA1c efficacy against other glucose monitoring methods.
- To assess the correlation between HgbA1c levels and mortality risk.
Main Methods:
- Comparative analysis of diagnostic tests for carbohydrate intolerance.
- Statistical correlation of HgbA1c values with mortality data.
- Evaluation of HgbA1c cost-effectiveness in risk assessment.
Main Results:
- Hemoglobin A1c (HgbA1c) values demonstrate superior accuracy in detecting carbohydrate intolerance compared to random serum glucose, serum fructosamine, and urine glucose.
- HgbA1c levels show a continuous correlation with mortality, starting between 5.0% and 6.0%.
- The cost of HgbA1c testing is significantly higher than routine serum chemistry panels.
Conclusions:
- HgbA1c is a valuable biomarker for identifying carbohydrate intolerance and predicting mortality risk.
- Underwriters can benefit from HgbA1c testing, especially given demographic trends towards obesity and aging.
- Despite its expense, HgbA1c provides critical information for assessing health risks.
Abstract:
Hemogloblin A1c (HgbA1c) values are superior to those of random serum glucose, serum fructosamine, and urine glucose as a means of detecting carbohydrate intolerance. Further, HgbA1c values have been shown to correlate with mortality in a continuous fashion beginning at levels between 5.0% and 6.0%. Unfortunately, the expense of HgbA1c testing is considerably higher than that of routine serum chemistry testing. Diabetes is an increasingly common disorder clearly associated with mortality. Also, the current demographic trends towards increasing age and increasing prevalence of obesity underscore the value to underwriters of identifying carbohydrate intolerance.