Journal of Diabetes Research (Jan 2015)

Diabetes Complications at Presentation and One Year by Glycated Haemoglobin at Diagnosis in a Multiethnic and Diverse Socioeconomic Population: Results from the South London Diabetes Study

  • Mohsin Azam,
  • Lindsey Marwood,
  • Khalida Ismail,
  • Tyrrell Evans,
  • Sobha Sivaprasad,
  • Kirsty Winkley,
  • Stephanie Anne Amiel

DOI
https://doi.org/10.1155/2015/587673
Journal volume & issue
Vol. 2015

Abstract

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Background. WHO’s recommendation of HbA1c≥48 mmol/mol (6.5%) as diagnostic for type 2 diabetes mellitus (T2DM) was adopted by three UK London boroughs in May 2012. The South London Diabetes (SOUL-D) study has recruited people with newly diagnosed T2DM since 2008. We compared participants diagnosed before May 2012 with HbA1c<48 mmol/mol to those with diagnostic HbA1c≥48 mmol/mol. Methods. A prospective cohort study of newly diagnosed T2DM participants from 96 primary care practices, comparing demographic and biomedical variables between those with diagnostic HbA1c<48 mmol/mol or HbA1c≥48 mmol/mol at recruitment and after one year. Results. Of 1488 participants, 22.8% had diagnostic HbA1c<48 mmol/mol. They were older and more likely to be white (p<0.05). At recruitment and one year, there were no between-group differences in the prevalence of diabetic complications, except that those diagnosed with HbA1c<48 mmol/mol had more sensory neuropathy at recruitment (p=0.039) and, at one year, had new myocardial infarction (p=0.012) but less microalbuminuria (p=0.012). Conclusions. Use of HbA1c≥48 mmol/mol as the sole T2DM diagnostic criterion may miss almost a quarter of those previously diagnosed in South London yet HbA1c<48 mmol/mol may not exclude clinically important diabetes.