Background: Identification of T2D high risk individuals is key for early implementation of prevention interventions. Employers could be instrumental in reversing T2D risk for a majority of its population via improved predictive power risk detection tools.
Objective: To test the feasibility of a two-step screening model, based on the combination of a risk test score and Hb1Ac, for early detection and management of risk in an employee population.
Methodology: The model was tested in nondiabetic employees of a large employer in Mexico. As a first step, a T2D risk score was computed for each participant via a multivariate logistic regression model that integrates 16 T2D genetic variants, T2D parental history and BMI. Subjects with a risk score above certain cut points were considered medium and high-risk individuals. As a second step, medium and high-risk individuals identified in the first step were tested for levels of Hb1Ac. Subjects with Hb1Ac of ≥5.7% were recommended to join the employer’s diabetes prevention program.
Results: 5,201 of 7,480 (69.5%) employees (46% women, 54% men) aged 18-60 years and free of diabetes agreed to participate in the screening program. 5,201 samples (buccal swabs) for genotyping and corresponding data (demographics, personal and family medical history) were collected on-site at 36 branch offices from 10/2017 to 12/2017 in Mexico City, Monterrey and Guadalajara. Participants risk scores stratified as low (52%), medium (34%) or high risk (14%). Of the medium and high-risk individuals, 31% showed elevated Hb1Ac (≥5.7%), and were suggested to join the employer’s diabetes prevention program.
Conclusions: Our study initiates a data-driven discussion of how employers can radically support employee diabetes prevention and lower healthcare costs via improved predictive power tools. A two-step system, based on the combination of a risk test score and Hb1Ac, may be a useful tool for an effective identification of high risk individuals in a workplace setting.
M. Zulueta: Employee; Self; Patia, Patia.