• An Analysis of Diabetes Predictors and Diagnostic Tests in a Sample of African Americans at Risk for Diabetes

      Williams, Lovoria B.; Department of Biobehavioral Nursing (2011-05)
      Recently the ADA and International Expert Committee (IEC) endorsed HbA1C for diagnosis of glucose states. Concerns exists regarding discordance between fasting plasma glucose (FPG) and HbA1C; the committees do not agree on the HbA1C cut-point for diagnosis of sub-diabetic states; and the HbA1C may be more sensitive in AAs. A secondary data analysis of the Fit Body and Soul (FBAS) sample (n = 393) was conducted. FPG and HbA1C values were classified by the current ADA and the IEC HbA1C criteria. A risk factor analysis was also conducted. Results indicate different subject classification based on choice of diagnostic test and criterion used. Subjects classified as normoglycemic based on ADA FPG, ADA HbA1C and IEC HbA1C criterion were (78.9%; 30.7%; 55%) of the sample, respectively. Sub-diabetic state was (18.1%; 55.9%; 31.5%), respectively. Diabetes was (3%; 13.4%; 13.4%), respectively. Moderate correlation exists between HbA1C and FPG (Pearson’s r = 0.63 p < 0.001); there is only slight to fair agreement between ADA HbA1C and ADA FPG classifications and IEC HbA1C and ADA FPG classifications; Cohen’s Kappa = 0.127; 0.234 (p < 0.001), respectively; McNemar’s Chi Square (χ23df = 182.8; 81.54 p < 0.001) respectively. Significant predictors of HbA1C by linear regression were waist circumference (WC) and age; FPG predictors were age, WC and family history of diabetes. The risk factor analysis indicated poor agreement with either diagnostic test.