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The Blood Bank for Diabetes Screening: a Feasible Alternative?
Insights
Blood banks can screen for diabetes mellitus (DM) using glycated hemoglobin (HbA1c) tests. This study found undiagnosed DM and pre-DM in blood donors, highlighting the potential for early detection and public health benefits.
Area of Science:
- Endocrinology
- Public Health
- Hematology
Background:
- Diabetes mellitus (DM) is a leading cause of global mortality, with vascular complications accounting for 5% of annual deaths.
- Early diagnosis and intervention are crucial for mitigating DM-related mortality.
- This project explored the prevalence of undiagnosed DM in blood donors and the feasibility of blood bank involvement in DM screening.
Purpose of the Study:
- To determine the frequency of undiagnosed diabetes mellitus among blood donors.
- To assess the potential role of blood banks in screening for diabetes mellitus.
Main Methods:
- Glycated hemoglobin (HbA1c) levels were measured in blood donors (n=635) aged 18-69.
- Donors were categorized based on HbA1c: <5.7% (low risk), 5.7-6.4% (pre-diabetes), and ≥6.5% (diabetes).
- A subsample (n=576) was assessed for 5-year DM risk based on HbA1c levels.
Main Results:
- 0.5% of donors had HbA1c levels indicative of diabetes, and 9.0% had levels suggesting pre-diabetes.
- In a 5-year risk assessment, 19.3% of donors were at moderate risk and 1.7% were at high risk for developing DM.
Conclusions:
- Blood bank screening using HbA1c can effectively identify new diabetes cases and individuals at elevated risk.
- Integrating DM screening into blood bank operations offers significant public health advantages.
- Blood banks can play a vital role in enhancing diabetes detection and management within the healthcare system.
Background:
Vascular complications of diabetes mellitus (DM) are associated with 5% of deaths globally every year. Early diagnosis and treatment could reduce this figure. The aim of this project was to investigate the frequency of undiagnosed DM among blood donors and the possibility of blood banks participating in DM screening.
Methods:
Of the approximate 5,600 candidates for blood donation who were evaluated, 4,601 were considered suitable. Candidates with any type of DM, hypertension, thyroid disease, and/or continuous use of any drugs were excluded, resulting in the participation of 635 donors aged 18 - 69 years. Glycated hemoglobin (HbA1c) levels were used to classify the donors: HbA1c < 5.7% (low risk of DM), HbA1c 5.7 - 6.4% (pre-diabetes), and HbA1c ≥ 6.5% (diabetes). Another subsample (n = 576) that excluded donors with HbA1c levels < 5.0% or > 6.5% were classified according to the risk of developing DM in 5 years: HbA1c 5 - 5.5% (low risk, < 9%), HbA1c 5.6 - 6.0% (moderate risk, 9 - 25%), and HbA1c 6.1 - 6.5% (high risk, 26 - 50%).
Results:
Three donors (0.5%) had HbA1c levels suggestive of DM, and 57 donors (9.0%) had levels associated with pre-DM. Regarding the risk of developing DM in 5 years, 111 donors (19.3%) were classified at moderate risk, and 10 donors (1.7%) were classified at high risk.
Conclusions:
DM screening in blood banks using HbA1c can identify new cases of DM and individuals at an increased risk of DM. In summary, blood banks could participate in DM screening, benefitting the general public and public health care system in Brazil.
