Lower diabetes risk test cutoff ups lab cost, identifies more persons with prediabetes

Use of the American Diabetes Association (ADA) Diabetes Risk Test (DRT) cutoff score of 4 as part of an employee wellness screening program to identify individuals at risk for developing the disease adds up to laboratory costs, reports a study.

However, it also provides earlier education, which then reduces or halts the progression to diabetes, thus lowering healthcare costs in the long run.

The researchers determined individuals at risk for developing diabetes during an employee wellness screening using a more stringent DRT cutoff score of 4 instead of 5. During the event, they extracted haemoglobin A1c (HbA1c) for those with a DRT score of ≥4 or by request regardless of risk score.

HbA1c values were classified as follows: normal (<5.7 percent), prediabetes (>5.7 percent and <6.5 percent), or diabetes (>6.5 percent). The researchers performed a descriptive analysis to estimate risk scores and HbA1c values. They also reviewed the cost of additional laboratory testing.

Overall, 158 participants had their HbA1c drawn for analysis. Of the 50 participants with a DRT of 4, 14 (28 percent) had HbA1c values in the prediabetes range and no history of diabetes or prediabetes.

Lowering the DRT cutoff score to 4 resulted in additional expenditure of $305, with $85.40 coming from the identification of an otherwise unaware person at risk for developing diabetes.

“The ADA DRT is a screening tool to identify people at risk for developing diabetes,” the researchers said. “Individuals with a DRT score of 5 or higher may have prediabetes or diabetes and should see a healthcare provider.”