Community screenings uncover hidden diabetes risk

Blood tests done in churches, community centers, shelters and busy street corners of the Bronx reveal that nearly a quarter of those tested had previously undiagnosed diabetes or were at high risk for developing the disease, according to a new report.

The number of newly diagnosed and high-risk individuals is in addition to the 11 percent of participants who previously had been diagnosed with diabetes, according to Charles Nordin, M.D., and colleagues of the Jacobi Medical Center, North Central Bronx Hospital and Albert Einstein School of Medicine. Their findings are published in the American Journal of Preventive Medicine.

Nordin and colleagues measured levels of hemoglobin A1c, a protein related to blood sugar intolerance, in 539 people at 20 screening centers. Hemoglobin A1c levels can also help doctors identify persons with cardiovascular disease risks like high blood pressure and high levels of LDL, or "bad" cholesterol.

"The inner city provides an ideal environment for such screening, because the number of patients at risk is high and the population density facilitates contact with large groups in such areas as street corners," Nordin explains.

"Ultimately one can hope that such interactions will bring more people into care," he adds.

About 20 percent of participants without a previous diabetes diagnosis had hemoglobin levels that placed them in the at-risk range for the disease, while 3.4 percent of those screened had levels high enough to be considered diabetic, the researchers found.

People screened at shelters had significantly lower hemoglobin A1c levels (meaning they were at lower risk of developing diabetes) than those screened in other locations. Shelter occupants also tended to be younger than most participants.

"Hemoglobin A1c values for people in the South Bronx, which has a high poverty rate, were also higher than those in the North Bronx," Nordin says.

Hemoglobin A1c tests are a good way to uncover disease risk in a community-based study because unlike other common diabetes tests, hemoglobin levels do not depend on how recently a person ate. Hemoglobin A1c levels are also more predictive of cardiovascular disease risks.

BY BECKY HAM, SCIENCE WRITER
HEALTH BEHAVIOR NEWS SERVICE

FOR MORE INFORMATION
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Charles Nordin at (718) 918-5643 or nordin@aecom.yu.edu.
American Journal of Preventive Medicine: Contact the editorial office at (858) 457-7292.

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