Ethnic differences in prevalence of actionable HbA1c levels in UK Biobank: implications for screening

BMJ Open Diabetes Res Care. 2021 Aug;9(1):e002176. doi: 10.1136/bmjdrc-2021-002176.

Abstract

Introduction: Early detection and treatment of diabetes as well as its prevention help lessen longer-term complications. We determined the prevalence of pre-diabetes and undiagnosed diabetes in the UK Biobank and standardized the results to the UK general population.

Research design and methods: This cross-sectional study analyzed baseline UK Biobank data on plasma glycated hemoglobin (HbA1c) to compare the prevalence of pre-diabetes and undiagnosed diabetes mellitus in white, South Asian, black, and Chinese participants. The overall and ethnic-specific results were standardized to the UK general population aged 40-70 years of age.

Results: Within the UK Biobank, the overall crude prevalence was 3.6% for pre-diabetes, 0.8% for undiagnosed diabetes, and 4.4% for either. Following standardization to the UK general population, the results were similar at 3.8%, 0.8%, and 4.7%, respectively. Crude prevalence was much higher in South Asian (11.0% pre-diabetes; 3.6% undiagnosed diabetes; 14.6% either) or black (13.8% pre-diabetes; 3.0% undiagnosed diabetes; 16.8% either) participants. Only six middle-aged or old-aged South Asian individuals or seven black would need to be tested to identify an HbA1c result that merits action.

Conclusions: Single-stage population screening for pre-diabetes or undiagnosed diabetes in middle-old or old-aged South Asian and black individuals using HbA1c could be efficient and should be considered.

Keywords: diabetes mellitus; early diagnosis; ethnic groups; glycated hemoglobin A; type 2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biological Specimen Banks*
  • Cross-Sectional Studies
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / ethnology
  • Ethnicity*
  • Glycated Hemoglobin* / analysis
  • Humans
  • Middle Aged
  • Prediabetic State* / diagnosis
  • Prediabetic State* / ethnology
  • Prevalence
  • United Kingdom / epidemiology

Substances

  • Glycated Hemoglobin A