Prevalence of hemoglobin A1c greater than 6.5% and 7.0% among hospitalized patients without known diagnosis of diabetes at an Urban Inner City Hospital

Jeremy A. Mazurek, Susan M. Hailpern, Tabitha Goring, Charles W. Nordin

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Abstract

Context: Bronx, New York, an urban county with a large low-income, immigrant and minority population, has a prevalence of diabetes that is among the highest in the United States. Objective: The aim of the study was to evaluate the utility of hemoglobin A1c (HbA1c) in identifying patients at risk for diabetes on an in-patient medical service of a hospital serving a high prevalence community. Design and Setting: We conducted a prospective cohort study at an urban public hospital. Patients: The study included 971 patients (1132 admissions) admitted to the general medicine service over 4 months. Main Outcome Measures: HbA1c was measured on all patients. Records were checked for prior diagnosis of diabetes and other clinical data. Follow-up data were obtained for those with repeat HbA1c testing or glucose within 1 yr after admission. Results: We found that 35.2% of the patients (n = 342) had an established diagnosis of diabetes. The remaining 629 patients defined the study cohort of patients without known diabetes. Mean HbA1c was 6.05 ± 0.87%. A total of 152 patients (24%) had admission HbA1c of at least 6.5% and 62 (9.9%) had HbA1c of at least 7.0%. Fifty-five patients with HbA1c of at least 6.5% had follow-up HbA1c within 1 yr. Of those, 44 (80.0%) met the criteria for diabetes as proposed by The International Expert Committee using repeated HbA1c testing. Conclusion: In communities with high prevalence of diabetes, a large percentage of patients without a diagnosis of diabetes who are admitted as in-patients have HbA1c of at least 6.5% and 7.0%. Hospital-based HbA1c testing might identify patients for whom further testing is indicated to make the diagnosis of diabetes.

Original languageEnglish (US)
Pages (from-to)1344-1348
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number3
DOIs
StatePublished - Mar 2010

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Urban Hospitals
Medical problems
Hemoglobins
Testing
Cohort Studies
Patient Admission
Public Hospitals
Medicine
Outcome Assessment (Health Care)
Prospective Studies
Glucose

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

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Prevalence of hemoglobin A1c greater than 6.5% and 7.0% among hospitalized patients without known diagnosis of diabetes at an Urban Inner City Hospital. / Mazurek, Jeremy A.; Hailpern, Susan M.; Goring, Tabitha; Nordin, Charles W.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 3, 03.2010, p. 1344-1348.

Research output: Contribution to journalArticle

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abstract = "Context: Bronx, New York, an urban county with a large low-income, immigrant and minority population, has a prevalence of diabetes that is among the highest in the United States. Objective: The aim of the study was to evaluate the utility of hemoglobin A1c (HbA1c) in identifying patients at risk for diabetes on an in-patient medical service of a hospital serving a high prevalence community. Design and Setting: We conducted a prospective cohort study at an urban public hospital. Patients: The study included 971 patients (1132 admissions) admitted to the general medicine service over 4 months. Main Outcome Measures: HbA1c was measured on all patients. Records were checked for prior diagnosis of diabetes and other clinical data. Follow-up data were obtained for those with repeat HbA1c testing or glucose within 1 yr after admission. Results: We found that 35.2{\%} of the patients (n = 342) had an established diagnosis of diabetes. The remaining 629 patients defined the study cohort of patients without known diabetes. Mean HbA1c was 6.05 ± 0.87{\%}. A total of 152 patients (24{\%}) had admission HbA1c of at least 6.5{\%} and 62 (9.9{\%}) had HbA1c of at least 7.0{\%}. Fifty-five patients with HbA1c of at least 6.5{\%} had follow-up HbA1c within 1 yr. Of those, 44 (80.0{\%}) met the criteria for diabetes as proposed by The International Expert Committee using repeated HbA1c testing. Conclusion: In communities with high prevalence of diabetes, a large percentage of patients without a diagnosis of diabetes who are admitted as in-patients have HbA1c of at least 6.5{\%} and 7.0{\%}. Hospital-based HbA1c testing might identify patients for whom further testing is indicated to make the diagnosis of diabetes.",
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N2 - Context: Bronx, New York, an urban county with a large low-income, immigrant and minority population, has a prevalence of diabetes that is among the highest in the United States. Objective: The aim of the study was to evaluate the utility of hemoglobin A1c (HbA1c) in identifying patients at risk for diabetes on an in-patient medical service of a hospital serving a high prevalence community. Design and Setting: We conducted a prospective cohort study at an urban public hospital. Patients: The study included 971 patients (1132 admissions) admitted to the general medicine service over 4 months. Main Outcome Measures: HbA1c was measured on all patients. Records were checked for prior diagnosis of diabetes and other clinical data. Follow-up data were obtained for those with repeat HbA1c testing or glucose within 1 yr after admission. Results: We found that 35.2% of the patients (n = 342) had an established diagnosis of diabetes. The remaining 629 patients defined the study cohort of patients without known diabetes. Mean HbA1c was 6.05 ± 0.87%. A total of 152 patients (24%) had admission HbA1c of at least 6.5% and 62 (9.9%) had HbA1c of at least 7.0%. Fifty-five patients with HbA1c of at least 6.5% had follow-up HbA1c within 1 yr. Of those, 44 (80.0%) met the criteria for diabetes as proposed by The International Expert Committee using repeated HbA1c testing. Conclusion: In communities with high prevalence of diabetes, a large percentage of patients without a diagnosis of diabetes who are admitted as in-patients have HbA1c of at least 6.5% and 7.0%. Hospital-based HbA1c testing might identify patients for whom further testing is indicated to make the diagnosis of diabetes.

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