Abstract
To describe a screening programme to detect undiagnosed diabetes in high-risk ethnic groups in New Zealand and determine the specificity and sensitivity of HbA(1c) to detect fasting hyperglycaemia. HbA(1c) was offered to subjects over 20 years of age participating in a screening programme for hepatitis B that was targeted at non-European populations. Two hundred and forty-four predominantly Maori subjects, with HbA(1c) levels 5 to 7.9% and who were not known to have diabetes, were tested with an oral glucose tolerance test. Comparison was made with fasting and 2-h samples. Fifty thousand eight hundred and nineteen subjects were screened using HbA(1c). 12% had HbA(1c) levels of 6.1% or more, and in 4% of the population HbA(1c) was 7.1% or more. Maori, Pacific Island people, and Indians had particularly high rates of elevated HbA(1c). HbA(1c) levels of 6.1% and greater were 94% sensitive and 77% specific in detecting the 32 subjects who had a fasting glucose of 7.0 mmol/L or more, and 90% sensitive and 73% specific for 20 subjects with a 2-h glucose of 11.1 mmol/L or more. Rates of elevated HbA(1c) levels in non-Europeans in New Zealand are very high, particularly in Maori, Pacific Island Peoples', and Indians, reflecting their h...Continue Reading
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