Integrating routine hemoglobin A1c screening in blood donation: A strategy for early diabetes detection and donor health awareness.
Source: PubMed, NCBI / U.S. National Library of Medicine
More than 1 in 10 adults worldwide have diabetes, with nearly 50% undiagnosed. Hemoglobin A1c (HbA1c) testing is widely available to identify disease status and blood donation centers can play a pivotal role in public health promotion with routine screening. We performed a prospective observational study implementing HbA1c testing at a community blood center over a 1-year period. Demographic data and history of pre-diabetes/diabetes status were collected. Donors with abnormally elevated HbA1c without disease history were notified of a new diabetes/pre-diabetes diagnosis. Overall, 17.7% of donors had elevated HbA1c levels. Strikingly, 64.9% of abnormal results represented new diagnoses, primarily pre-diabetes (91.6%). Significant differences in the proportions of new diagnoses were found by donor type (whole blood, platelets) and demographic (age, gender, ethnicity). Donors with abnormal HbA1c values donated significantly more frequently than those with normal HbA1c values. Finally, 17.8% of donors with new diagnoses reported acknowledgement of the new diagnoses on a subsequent donation in the study period. Incorporating HbA1c testing in blood donation centers is an effective strategy for early diabetes detection, underscored by the substantial proportion of new diagnoses. Further, observed differences across donation types and demographic groups reveal disproportionately underdiagnosed populations for targeted outreach. Moreover, enhanced follow-up strategies are warranted to
Abstract
More than 1 in 10 adults worldwide have diabetes, with nearly 50% undiagnosed. Hemoglobin A1c (HbA1c) testing is widely available to identify disease status and blood donation centers can play a pivotal role in public health promotion with routine screening. We performed a prospective observational study implementing HbA1c testing at a community blood center over a 1-year period. Demographic data and history of pre-diabetes/diabetes status were collected. Donors with abnormally elevated HbA1c without disease history were notified of a new diabetes/pre-diabetes diagnosis. Overall, 17.7% of donors had elevated HbA1c levels. Strikingly, 64.9% of abnormal results represented new diagnoses, primarily pre-diabetes (91.6%). Significant differences in the proportions of new diagnoses were found by donor type (whole blood, platelets) and demographic (age, gender, ethnicity). Donors with abnormal HbA1c values donated significantly more frequently than those with normal HbA1c values. Finally, 17.8% of donors with new diagnoses reported acknowledgement of the new diagnoses on a subsequent donation in the study period. Incorporating HbA1c testing in blood donation centers is an effective strategy for early diabetes detection, underscored by the substantial proportion of new diagnoses. Further, observed differences across donation types and demographic groups reveal disproportionately underdiagnosed populations for targeted outreach. Moreover, enhanced follow-up strategies are warranted to improve donor awareness of disease status. Finally, donation behavior changes were observed in those with pre/diabetes, highlighting the feasibility of incorporating screening, though distinct trends in subgroups define key considerations to optimize public health impact.