Identifying persons at risk for developing type 2 diabetes in a concentrated population of high risk ethnicities in Canada using a risk assessment questionnaire and point-of-care capillary blood HbA1c measurement

Background: Amidst the growing health care burden created by diabetes, this study aimed to assess the utility of a prediabetes/type 2 diabetes risk questionnaire in high risk ethnic communities in Toronto Canada. Methods: Participants (n = 691) provided questionnaire responses and capillary blood tests collected via fingerstick and results were analysed for HbA(1c) using the Bio-Rad in2it point-of-care device. The Bland-Altman method was used to compare point-of-care HbA(1c) analysis (Bio-Rad, boronate affinity chromatography) to that using high performance liquid chromatography. ANOVA and linear regression were performed to investigate the relationship between questionnaire and blood data. Results: Mean (+/- SD) HbA(1c) was 5.99% +/- 0.84 and the Bland-Altman analysis revealed no significant biases HbA(1c) (bias = 0.039, 95% limits of agreement = -1.14 to 1.22). ANOVA showed that with increasing risk classification based on questionnaire answers (with the exception of "moderate"-to-"high"), there was a significant increase in mean HbA(1c) (Welch Statistic 30.449, p < 0.001). Linear regression revealed that the number of high risk parents, age category, BMI, physical activity participation and previous diagnosis of high blood sugar were significant contributors (p < 0.05) to the variance in HbA(1c). Conclusions: Though not a substitute for established diagnostic protocols, the use of a risk questionnaire can be an accurate, low cost, educational and time efficient method for assessment of type 2 diabetes risk. The early detection of prediabetes and type 2 diabetes is vital to increased awareness and opportunity for intervention with the goal of preventing or delaying the progression of type 2 diabetes and the known associated complications.