By Lisa Rapaport
(Reuters Health) – Screening black men for diabetes in barbershops may help identify those who don’t realize they have the disease, a new study suggests.
In the United States, black men with diabetes are much more likely to develop complications and less likely to survive into their 70s than men in other racial and ethnic groups, researchers note in JAMA Internal Medicine. One reason may be that many black men at risk for diabetes go undiagnosed, particularly when they don’t have a primary care provider.
For the current study, researchers screened 290 black men for diabetes at eight barbershops owned by black individuals in Brooklyn, New York, neighborhoods where many people with diabetes have poorly controlled blood sugar. Overall, 29 men, or 10% of the participants, had blood sugar levels high enough to be diagnosed with diabetes.
These results suggest that barbershops, which have also been used to screen men for high blood pressure, might be a good place to try to diagnose diabetes, especially among people who don’t have symptoms or regular checkups, the study team concludes.
“Often our use of healthcare is in response to some symptoms that we are having,” said senior study author Dr. David Lee of New York University School of Medicine.
“But then some chronic diseases do not have any symptoms until the disease has been damaging our bodies for years,” Lee said by email.
To test the feasibility of screening men for undiagnosed diabetes in barber shops, researchers used a finger-prick blood test that gives results in five minutes. The test estimates a person’s average blood sugar levels over the course of about three months by measuring how much of the hemoglobin proteins in red blood cells are coated in sugar.
So-called hemoglobin A1c levels of 6.5% or above signal diabetes, and 29 men had blood sugar at least this high. Three men had A1c levels of at least 7.5%, putting them at high risk for complications.
A1c levels between 5.7% and 6.4% are considered elevated, though not yet diabetic, and 82 men, or about 28% of the participants, fell into this category. Past research suggests that about a third of people with this kind of elevated blood sugar will progress to full diabetes, and doctors sometimes advise making lifestyle changes like improving diet and exercise habits to avoid this.
Many of the men with undiagnosed diabetes were obese, which is a risk factor for the disease.
Beyond the study’s small size, another limitation is the potential for outcomes to be different at other barbershops in different neighborhoods or cities, the study team notes.
In addition, the rapid A1c test used in the study isn’t as accurate as tests that require vials of blood to be sent to a lab, researchers note. Men diagnosed with a rapid test would still need to get another test to confirm they have diabetes.
It’s also not clear whether screening led men to get follow-up care for diabetes, said Dr. Alexander Turchin of Brigham and Women’s Hospital and Harvard Medical School in Boston.
“If they had barriers to being screened for diabetes, they may also have – the same – barriers to being treated for it,” Turchin, who wasn’t involved in the study, said by email. “Consequently what we ultimately need to know is whether people who go to barbershops with a screening program and are diagnosed there with diabetes are, at the end of the day, able to get their blood sugars down.”
SOURCE: https://bit.ly/2RtkbIB JAMA Internal Medicine, online January 27, 2020.