Single, community-based blood glucose readings may be a viable alternative for community surveillance of HbA1c and poor glycaemic control in people with known diabetes in resource-poor settings

Background: The term HbA1c (glycated haemoglobin) is commonly used in relation to diabetes mellitus. The measure gives an indication of the average blood sugar levels over a period of weeks or months prior to testing. For most low- and middle-income countries HbA1c measurement in community surveilla...

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Main Authors: Daniel D. Reidpath (Author), Nowrozy K. Jahan (Author), Devi Mohan (Author), Pascale Allotey (Author)
Format: Book
Published: Taylor & Francis Group, 2016-08-01T00:00:00Z.
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001 doaj_9f14a089bd9d4b9e9ff6dd9281f6a76d
042 |a dc 
100 1 0 |a Daniel D. Reidpath  |e author 
700 1 0 |a Nowrozy K. Jahan  |e author 
700 1 0 |a Devi Mohan  |e author 
700 1 0 |a Pascale Allotey  |e author 
245 0 0 |a Single, community-based blood glucose readings may be a viable alternative for community surveillance of HbA1c and poor glycaemic control in people with known diabetes in resource-poor settings 
260 |b Taylor & Francis Group,   |c 2016-08-01T00:00:00Z. 
500 |a 1654-9880 
500 |a 10.3402/gha.v9.31691 
520 |a Background: The term HbA1c (glycated haemoglobin) is commonly used in relation to diabetes mellitus. The measure gives an indication of the average blood sugar levels over a period of weeks or months prior to testing. For most low- and middle-income countries HbA1c measurement in community surveillance is prohibitively expensive. A question arises about the possibility of using a single blood glucose measure for estimating HbA1c and therefore identifying poor glycaemic control in resource-poor settings. Design: Using data from the 2011-2012 US National Health and Nutrition Examination Surveys, we examined the relationship between HbA1c and a single fasting measure of blood glucose in a non-clinical population of people with known diabetes (n=333). A linear equation for estimating HbA1c from blood glucose was developed. Appropriate blood glucose cut-off values were set for poor glycaemic control (HbA1c≥69.4 mmol/mol). Results: The HbA1c and blood glucose measures were well correlated (r=0.7). Three blood glucose cut-off values were considered for classifying poor glycaemic control: 8.0, 8.9, and 11.4 mmol/L. A blood glucose of 11.4 had a specificity of 1, but poor sensitivity (0.37); 8.9 had high specificity (0.94) and moderate sensitivity (0.7); 8.0 was associated with good specificity (0.81) and sensitivity (0.75). Conclusions: Where HbA1c measurement is too expensive for community surveillance, a single blood glucose measure may be a reasonable alternative. Generalising the specific results from these US data to low resource settings may not be appropriate, but the general approach is worthy of further investigation. 
546 |a EN 
690 |a diabetes 
690 |a blood glucose 
690 |a HbA1c 
690 |a glycaemic control 
690 |a community surveillance 
690 |a developing countries 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Global Health Action, Vol 9, Iss 0, Pp 1-7 (2016) 
787 0 |n http://www.globalhealthaction.net/index.php/gha/article/view/31691/pdf_328 
787 0 |n https://doaj.org/toc/1654-9880 
856 4 1 |u https://doaj.org/article/9f14a089bd9d4b9e9ff6dd9281f6a76d  |z Connect to this object online.