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Detecting undiagnosed diabetes using glycated haemoglobin: an automated screening test in hospitalised patients

Nyoli A Valentine1, Tariq M Alhawassi, Greg W Roberts

  • 1Sturt Fleurieu General Practice Education and Training, Adelaide, SA, Australia.

The Medical Journal of Australia
|March 16, 2011
PubMed

Insights

Automated glycated haemoglobin (HbA1c) screening effectively identifies undiagnosed diabetes in hospitalized patients. This cost-effective method reveals an 11% prevalence, highlighting the need for integrated community management strategies.

Area of Science:

  • Clinical Medicine
  • Endocrinology
  • Public Health

Background:

  • Undiagnosed diabetes poses a significant public health challenge.
  • Hospitalized patients represent a key demographic for identifying undiagnosed diabetes.
  • Current screening methods may have limitations in accuracy and efficiency.

Purpose of the Study:

  • To evaluate glycated haemoglobin (HbA1c) as an automated screening tool for undiagnosed diabetes in hospitalized individuals.
  • To determine the prevalence of previously unrecognized diabetes mellitus among this patient population.

Main Methods:

  • A prospective 3-month study involving adult patients admitted to a tertiary hospital.
  • Automated HbA1c testing was performed on admission for patients with random plasma glucose (RPG) ≥ 5.5 mmol/L.
  • Data on demographics, admissions, and biochemistry were collected; a subset underwent post-discharge oral glucose tolerance tests (OGTT).

Main Results:

  • The prevalence of undiagnosed diabetes was 11% (95% CI, 9.8%-12.4%), with higher rates in the 65-74 age group.
  • Automated HbA1c testing proved more effective than RPG screening.
  • The cost per new diagnosis was $152, with an estimated ongoing cost of $2100 annually.
  • Post-discharge OGTT compliance was low (27%).

Conclusions:

  • Glycated haemoglobin (HbA1c) offers a simple, automated, and cost-effective method for screening undiagnosed diabetes in hospitalized patients.
  • Effective hospital screening requires concurrent community-based management resources.
  • Automated HbA1c testing is a valuable tool for identifying diabetes in acute care settings.
Abstract

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