Abstract
Background: The Centers for Disease Control recently recommended that community-based screening for diabetes be discontinued due to their low yield of incident cases and challenges in the follow-up for abnormal cases. Moreover, community-based screenings for diabetes are not considered efficacious even in high-risk populations. The purpose of this study is to evaluate the characteristics associated with random abnormal blood glucose readings among African Americans in order to determine the potential value of a more targeted approach to community-based screenings.
Methods: Data were collected from participants of an ongoing community-based screening study at screening events hosted by a large urban health care system. Data collected included gender, race, age, self-reported height and weight, health history, blood pressure (BP), and random blood glucose. Individual parameters were analyzed in a univariate logistic regression model; parameters with P<0.20 were then considered in a multivariable logistic regression model. The final model was selected using the backward selection method and retained parameters with P<0.05.
Results: Between October 1999 and September 2002, there were a total of 5485 participants. Of these, 89% were African American, 61% were female, and the mean age was 49.8 (SD=15.88). Eighty-eight percent (4832) had never been previously diagnosed with diabetes and among these, 274 (5.7%) had an abnormal blood glucose reading. Results indicated that age, BP, and body mass index (BMI) were significantly associated with abnormal glucose readings (all P-values <0.001). Among participants who had never been diagnosed with diabetes, those who were 50 years or older were 1.7 times more likely to have an abnormal glucose reading compared to participants <50 years (OR: 1.74; 95% CI: 1.33, 2.27). Participants with abnormal BP screenings were 1.4 times more likely to have an abnormal glucose reading (OR: 1.44; 95% CI: 1.09, 1.90). In addition, increasing BMI was associated with abnormal glucose readings. More specifically, for every 1-unit increase in BMI, the odds of having an abnormal glucose reading increased 4.7% (OR: 1.047; 95% CI: 1.028, 1.066).
Conclusions: Age, abnormal BP, and BMI are all associated with random abnormal blood glucose readings among those with no previous diagnosis with diabetes. These findings suggest that more research is needed in order to determine the value of a more targeted approach to community-based screenings for diabetes.
- Received September 11, 2008.
