Hemoglobin variants detected by hemoglobin A1c (HbA1c) analysis and the effects on HbA1c measurements

Nasir, Nadzimah Mohd; Thevarajah, M.; Yean, Chew Yee

doi:10.4103/0973-3930.62598

Cited by 48 publications

(18 citation statements)

References 16 publications

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“…Second, under the logistical constraints, HbA1c and FPG were used to diagnose DM instead of the oral glucose tolerance test recommended by the WHO [16]; these tests could be a practical option as a feasible method for detecting DM in seroprevalence surveys in settings with limited resources. Third, hemoglobinopathy, which is a relatively prevalent disorder in Southeast Asia, can compromise the consistency of results for DM diagnosis because it affects HbA1c levels [22, 23]. Therefore, in this study, we excluded one suspected case that demonstrated apparent discordance between HbA1c and FPG levels without laboratory testing for confirmation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, perception and factors associated with diabetes mellitus among the adult population in central Vietnam: a population-based, cross-sectional seroepidemiological survey

et al. 2017

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BackgroundDiabetes Mellitus (DM) has rapidly become a major public health concern in Vietnam. Although the prevalence of DM has been studied in northern and southern Vietnam, little data are available for the central region. Therefore, the aims of this survey were to estimate the prevalence of DM and to identify the perception of and factors associated with DM among the adult population in central Vietnam.MethodsWe conducted a cross-sectional, population-based survey in Khánh Hòa Province, Vietnam in December 2014 using three-stage cluster sampling and probability proportional to size sampling in line with the World Health Organization STEPwise approach. Four hundred and eighty residents aged 20–70 years were selected from 30 villages in 10 wards/communes. After obtaining informed consent, all residents participated in interviews regarding lifestyle, medical history, and perception of DM and underwent physical measurements and blood examination for fasting blood glucose and glycated hemoglobin. Factors associated with DM were analyzed using a logistic regression model.ResultsA total of 376 residents were enrolled (response rate: 78.3%; females: 59%; rural residents: 61%). Among the participants, 14.3% and 18.9% of males and females, respectively, were classified as overweight/obese according to body mass index (BMI), 37.7% and 22.1%, respectively, had hypertension, and 36.4% and 11.7% had metabolic syndrome. The prevalence of DM in the entire population was 7.2% (27/376; 95% confidence interval [CI]: 4.6–9.8). Participants aged 60–70 years were more likely to have DM than those aged 30–39 years (adjusted odds ratio [aOR]: 8.7; 95%CI: 1.4–56.0), and participants classified as obese were more likely to have DM than those with normal or low BMI (aOR: 10.2; 95%CI: 2.2–50.2). Furthermore, more than two-thirds (254/376, 67.6%) of the participants either did not understand or had never heard of DM, and less than half of the DM cases (12/27, 44%) were aware of their history of DM.ConclusionsThe results of this study suggested that the prevalence of DM among the adult population in central Vietnam was slightly higher than that in other areas. Additional research is needed to further explore perceptions of and practices regarding DM.

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Section: Discussionmentioning

confidence: 99%

Prevalence, perception and factors associated with diabetes mellitus among the adult population in central Vietnam: a population-based, cross-sectional seroepidemiological survey

et al. 2017

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“…With the limited interpretation which can come from a single RBS and difficulty in obtaining a fasting blood sugar in a voluntary impromptu screening, there is considerable need for more contextualized strategies [23]. As access to point of care A1c testing is expanded in resource-constrained settings, it is hoped that questions about its accuracy in these populations can be addressed and subsequently be integrated into home-based screening and care to continue to improve the ease with which patients can be screened to confirm diabetes [24,25]. …”

Section: Discussionmentioning

confidence: 99%

Screening for diabetes and hypertension in a rural low income setting in western Kenya utilizing home-based and community-based strategies

et al. 2013

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BackgroundThe burdens of hypertension and diabetes are increasing in low- and middle-income countries (LMICs). It is important to identify patients with these conditions early in the disease process. The goal of this study, therefore, is to compare community- versus home-based screening for hypertension and diabetes in Kenya.MethodsThis was a feasibility study conducted by the Academic Model Providing Access to Healthcare (AMPATH) program in Webuye, a town in western Kenya. Home-based (door-to-door) screening occurred in March 2010 and community-based screening in November 2011. HIV counselors were trained to screen for diabetes and hypertension in the home-based screening with local district hospital based staff conducting the community-based screening. Participants >18 years old qualified for screening in both groups. Counselors referred all participants with a systolic blood pressure (SBP) ≥160 mmHg and/or a random blood glucose ≥7 mmol/L (126 mg/dL) to a local clinic for follow-up. Differences in likelihood of screening positive between the two strategies were compared using Fischer’s Exact Test. Logistic regression models were used to identify factors associated with the likelihood of following-up after a positive screening.ResultsThere were 236 participants in home-based screening: 13 (6%) had a SBP ≥160 mmHg, and 54 (23%) had a random glucose ≥ 7 mmol/L. There were 346 participants in community-based screening: 35 (10%) had a SBP ≥160 mmHg, and 27 (8%) had a random glucose ≥ 7 mmol/L. Participants in community-based screening were twice as likely to screen positive for hypertension compared to home-based screening (OR=1.93, P=0.06). In contrast, participants were 3.5 times more likely to screen positive for a random blood glucose ≥7 mmol/L with home-based screening (OR=3.51, P<0.01). Rates for following-up at the clinic after a positive screen were low for both groups with 31% of patients with an elevated SBP returning for confirmation in both the community-based and home-based group (P=1.0). Follow-up after a random glucose was also low with 23% returning in the home-based group and 22% in the community-based group (P=1.0).ConclusionCommunity- or home-based screening for diabetes and hypertension in LMICs is feasible. Due to low rates of follow-up, screening efforts in rural settings should focus on linking cases to care.

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“… 8 Extending set target HbA1c values to this group of patients may be erroneous due to potential risk of hypoglycaemia. 9 …”

Section: Discussionmentioning

confidence: 99%

Rising HbA1c in the presence of optimal glycaemic control as assessed by self-monitoring – iron deficiency anaemia

et al. 2016

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Hemoglobin variants detected by hemoglobin A1c (HbA1c) analysis and the effects on HbA1c measurements

Cited by 48 publications

References 16 publications

Prevalence, perception and factors associated with diabetes mellitus among the adult population in central Vietnam: a population-based, cross-sectional seroepidemiological survey

Prevalence, perception and factors associated with diabetes mellitus among the adult population in central Vietnam: a population-based, cross-sectional seroepidemiological survey

Screening for diabetes and hypertension in a rural low income setting in western Kenya utilizing home-based and community-based strategies

Rising HbA1c in the presence of optimal glycaemic control as assessed by self-monitoring – iron deficiency anaemia

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