Can HbA1c be used to screen for glucose abnormalities among adults with severe mental illness?
Poster C5,
Ahmed Jerome Romain1, Elaine Letendre2, Zeina Akrass1, Antoine Avignon3,4, Antony Karelis5, Ariane Sultan3,4, Amal Abdel-Baki1,2,6; 1University of Montreal Hospital Research Centre (CRCHUM), 2University Hospital of Montreal (CHUM), 3University Hospital of Montpellier, 4University of Montpellier, 5University of Quebec at Montreal, 6University of Montreal
Purpose: To investigate whether glycated hemoglobin (HbA1c) (which does not require fasting state) could be used as the only screening test of prediabetes and type 2 diabetes among individuals with serious mental illness (SMI) compared to the oral glucose tolerance test (OGTT) and fasting glucose (FG). Methods: Cross sectional study comparing the agreement between the three markers of diagnostic and the sensitivity of HbA1c, FG, and 2-h OGTT to detect prediabetes and type 2 diabetes in SMI participants referred for metabolic complications in two different clinics (Montreal, Canada; Montpellier, France). Results: A total of 84 participants with SMI (43 female; aged: 38.5 ± 12.8 years; BMI: 35.0 ± 6.8 kg/m²) was included. Regarding prediabetes, 44% of cases were identified by HbA1c, FG (44%), and 2h-OGTT (76%) respectively. Then, for Type 2 diabetes, 60%, of cases were identified by HbA1c, FG (53%) and 2h-OGTT (66%). The overlap between the three markers was low (8% of participants for prediabetes and 26% for Type 2 diabetes). Sensitivity of HbA1c were moderate (range 40%-62.5%), while its specificity was excellent (92-93%). Conclusion: The present study indicates a low agreement between HbA1c, FG and 2-h OGTT. Furthermore, it appears that these markers do not identify the same participants. Thus, HbA1c may not be used alone to detect all glucose abnormalities among adults with SMI, but could certainly be a useful tool for those unable to show up in a fasting state.
Topic Area: Epidemiology