Using Dried Blood Spots to Estimate the Prevalence of Elevated Glycosylated Hemoglobin and Undiagnosed Diabetes among Spanish Speakers in the Southwest

Steven A. Haas, Arizona State University

Diabetes is a major cause of morbidity and mortality in the US. Prevalence of diabetes among Hispanics is nearly twice that of non-Hispanic whites. Similarly, age-adjusted mortality rates from diabetes are 50% higher for Hispanics. One explanation for this may be high rates of uninsured among Hispanics leading to undiagnosed and poorly managed diabetes leading to greater complications and comorbidity. Given their marginal legal and economic status, recent immigrant arrivals and those with limited or no English proficiency may be at particularly high risk for undiagnosed diabetes. This paper uses dried blood spot techniques to estimate the prevalence of elevated glycosylated hemoglobin (HbA1c) and undiagnosed diabetes in a population-based sample of spanish speakers in the Phoenix metro area. We find that more than 30% have elevated HbA1c and nearly a quarter have undiagnosed diabetes. We also find significant educational disparities in these outcomes.