Introduction & Objective: Early detection of type 2 diabetes mellitus (T2DM) increases the quality of life and the life expectancy of individuals with T2DM and reduces societal health care costs. The aim of the study is to evaluate the efficiency of targeted and free screening using at-home self-sampling A1c tests for early detection of T2DM.
Methods: In October 2022 to June 2023, the Danish Diabetes Association mailed free capillary at-home self-sampling A1c tests to 8,000 randomly selected individuals aged 50 to 75 years, who had not had their A1c measured within the past two years. The Clinical Laboratory Information Register, including all laboratory measurements covering hospitals and GPs, was used to identify the population.
Results: 3,040 individuals, 38%, returned a blood sample. This is in line with screening studies for other diseases in Denmark. The participation rate was 3.8 %-points higher for women than for men and approximately U-shaped across age for both sexes with the highest participation rate among the 50-year-olds. The age-adjusted share of participants with A1c of 42-47 mmol/mol was 11%, equivalent to the estimated share of individuals with unknown prediabetes in the Danish population aged 50-75 years. The age-adjusted share of the participants with A1c ≥48 mmol/mol was 1.2% for women and 2.5% for men. It is slightly lower than the estimated shares of individuals with unknown T2DM, 1.6% for women and 2.7% for men. Further, individuals between 50-59 years of age constituted 51% of the participants with A1c ≥48 mmol/mol compared to 40% of the population, when diagnosed by the Danish Health Care System (DHCS). Similarly, the median A1c was 52 mmol/mol among the participants with A1c ≥48 mmol/mol compared to a median A1c of 60 mmol/mol in the population, when diagnosed with T2DM by the DHCS.
Conclusion: The pilot screening study for at-home self-sampling prove highly efficient in detecting individuals with A1c ≥48 mmol/mol earlier compared to individuals in the same age group diagnosed by the DHCS.
N. Cayuelas Mateu: Research Support; Novo Nordisk A/S, Bayer Inc., Boehringer-Ingelheim, Sanofi, AstraZeneca, Abbott, Abbott Diagnostics. P. Rossing: Other Relationship; AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Gilead Sciences, Inc., Novo Nordisk, Eli Lilly and Company, Novartis AG, Abbott Diagnostics. K.P. Neergaard: None. T. Thybo: Research Support; Novo Nordisk A/S, Bayer Inc., Boehringer-Ingelheim, Sanofi, AstraZeneca, Abbott, Abbott Diagnostics.
