Health Disparities

For diabetes screening, race matters

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Science  13 Oct 2017:
Vol. 358, Issue 6360, pp. 184
DOI: 10.1126/science.358.6360.184-b

Type 2 diabetes is diagnosed and monitored by a blood test for HbA1c, a modified form of hemoglobin produced when blood glucose is high. HbA1c levels can be influenced by genetic variants unrelated to glucose homeostasis. To examine whether such variants affect the reliability of the HbA1c test, Wheeler et al. studied 60 genetic variants in nearly 160,000 people of different ancestries. They identified a specific variant that, by shortening the lifespan of red blood cells, reduced HbA1c levels irrespective of blood glucose. This variant occurs almost exclusively in individuals of African ancestry. The results suggest that about 650,000 African Americans with type 2 diabetes may be misdiagnosed as healthy if they are screened solely by the HbA1c test.

PLOS Med. 10.1371/journal.pmed.1002383 (2017).

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