Screening for diabetes mellitus in a semi-rural South African cohort using glycated haemoglobin (HbA1c)

Abstract

It is estimated that between 30% and 50% of people with diabetes mellitus are undiagnosed. The purpose of this study was to investigate the prevalence of diabetes in a semi-rural population using glycated haemoglobin (HbA1c) and to examine the correlation between HbA1c and selected risk factors of type 2 diabetes. Using a descriptive research design, data were collected from semi-rural adults (42 males: mean age = 37.81±9.41 years; 56 females: mean age = 38.93±8.69 years) from the Secunda area of Mpumalanga province, South Africa. Participants’ HbA1c measurements were evaluated and analysed based on age, gender, body mass, height, body mass index (BMI), waist circumference, family history, blood pressure, resting heart rate, smoking, and exercise status. Pearson’s bivariate correlation method was used to examine correlations between HbA1c levels and selected risk factors of type 2 diabetes. The average HbA1c was 5.12 ±0.88%. HbA1c was normal in 71.4% of the participants, elevated in 13.3%, high in 9.2% and low in 6% of the cohort. The results also showed significant correlations between HbA1c and age (r=0.219; p=0.030), body mass (r=0.226; p=0.025), waist circumference (r=0.281; p=0.005) and a family history of diabetes (r=0.313; p=0.002). The results indicate that a high percentage of participants had elevated blood glucose levels and were either undiagnosed diabetics or pre-diabetic. In addition, increasing age, higher body mass, increased waist circumference and a family history of diabetes were significantly correlated with higher HbA1c levels. These findings support the need for more community testing for diabetes, taking into account inclusion of multiple risk factors like family history, age, body mass and waist circumference, when screening for diabetes in semi-rural populations.