Can HbA1c be used to screen for glucose abnormalities among adults with severe mental illness?

Poster C5, Saturday, October 22, 11:30 am - 1:00 pm, Le Baron

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

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