Value of glycated hemoglobin in the diagnosis of diabetes and prediabetes in cancer patients

Abstract

Glycated haemoglobin (HbA1c) level is now recognized a diagnostic tool for diabetes and prediabetes. Cancer patients constitute risk group for these conditions. A five-month hospital-based cross-sectional study was carried out in the town of Douala, aiming to determine the prevalence of diabetes and prediabetes in cancer patients, evaluate the diagnosis performance of HbA1c and identify factors underlying its performance. Questionnaire and medical records were used to document patients’ data and venous blood was collected to measure fasting plasma glucose (FPG) and HbA1c level. Haemoglobin count was also performed. In total, 172 women were enrolled and grouped into cervical cancer cohort (CCC, n =74), breast cancer cohort (BCC, n = 69) and control cohort (CC, n = 29). Based on FPG results, the prevalence of diabetes and prediabetes were 17.6 % and 13.5% respectively in the CCC, 20.3% and 10.1% in the BCC, 17.2% and 24.1% in the CC (p < 0.05). The prevalence of anaemia in these groups was 85.1%, 71.0% and 62.1% respectively (p = 0.0259). The sensitivity of HbA1c was 53.8% and 85.7% in CCC and BCC respectively while the specificity was 93.4 % and 90.8 % respectively. Agreement between HbA1c and FPG results was excellent in the CC but moderate CCC and BCC. Our findings suggest that HbA1c should not be recommended for the diagnosis of diabetes in cancer patients