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IDENTIFYING PROBABLE DIABETES MELLITUS AMONG HISPANICS/LATINOS FROM FOUR U.S. CITIES: FINDINGS FROM THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS.

TitleIDENTIFYING PROBABLE DIABETES MELLITUS AMONG HISPANICS/LATINOS FROM FOUR U.S. CITIES: FINDINGS FROM THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS.
Publication TypePublication
Year2016
AuthorsM Avilés-Santa L, Schneiderman N, Savage PJ, Kaplan RC, Teng Y, Pérez CM, Suárez EL, Cai J, Giachello AL, Talavera GA, Cowie CC
JournalEndocr Pract
Volume22
Issue10
Pagination1151-1160
Date Published2016 Oct
ISSN1530-891X
KeywordsAdolescent, Adult, Aged, Cardiovascular Diseases, Cities, Community Health Services, Cross-Sectional Studies, Diabetes Mellitus, Female, Hispanic Americans, Humans, Male, Middle Aged, Prevalence, Risk Factors, United States, Young Adult
Abstract

OBJECTIVE: The aim of this study was to compare the ability of American Diabetes Association (ADA) diagnostic criteria to identify U.S. Hispanics/Latinos from diverse heritage groups with probable diabetes mellitus and assess cardiovascular risk factor correlates of those criteria.METHODS: Cross-sectional analysis of data from 15,507 adults from 6 Hispanic/Latino heritage groups, enrolled in the Hispanic Community Health Study/Study of Latinos. The prevalence of probable diabetes mellitus was estimated using individual or combinations of ADA-defined cut points. The sensitivity and specificity of these criteria at identifying diabetes mellitus from ADA-defined prediabetes and normoglycemia were evaluated. Prevalence ratios of hypertension, abnormal lipids, and elevated urinary albumin-creatinine ratio for unrecognized diabetes mellitus-versus prediabetes and normoglycemia-were calculated.RESULTS: Among Hispanics/Latinos (mean age, 43 years) with diabetes mellitus, 39.4% met laboratory test criteria for probable diabetes, and the prevalence varied by heritage group. Using the oral glucose tolerance test as the gold standard, the sensitivity of fasting plasma glucose (FPG) and hemoglobin A1c-alone or in combination-was low (18, 23, and 33%, respectively) at identifying probable diabetes mellitus. Individuals who met any criterion for probable diabetes mellitus had significantly higher (P<.05) prevalence of most cardiovascular risk factors than those with normoglycemia or prediabetes, and this association was not modified by Hispanic/Latino heritage group.CONCLUSION: FPG and hemoglobin A1c are not sensitive (but are highly specific) at detecting probable diabetes mellitus among Hispanics/Latinos, independent of heritage group. Assessing cardiovascular risk factors at diagnosis might prompt multitarget interventions and reduce health complications in this young population.ABBREVIATIONS: 2hPG = 2-hour post-glucose load plasma glucose ADA = American Diabetes Association BMI = body mass index CV = cardiovascular FPG = fasting plasma glucose HbA1c = hemoglobin A1c HCHS/SOL = Hispanic Community Health Study/Study of Latinos HDL-C = high-density-lipoprotein cholesterol NGT = normal glucose tolerance NHANES = National Health and Nutrition Examination Survey OGTT = oral glucose tolerance test TG = triglyceride UACR = urine albumin-creatinine ratio.

DOI10.4158/EP151144.OR
Alternate JournalEndocr Pract
PubMed ID27295013
PubMed Central IDPMC6339459
Grant ListN01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
Z99 HL999999 / / Intramural NIH HHS / United States
MS#: 
0024B
Manuscript Lead/Corresponding Author Affiliation: 
NHLBI - National Heart, Lung, and Blood Institute (NHLBI is the lead NIH sponsor & Project Office for HCHS)
ECI: 
Manuscript Affiliation: 
NHLBI - National Heart, Lung, and Blood Institute (NHLBI is the lead NIH sponsor & Project Office for HCHS)
Manuscript Status: 
Published