Haemoglobin A1c-based screening for prediabetes and diabetes mellitus: a multi-center study in Croatian adult population.

INTRODUCTION: Based on the hypothesis that there is a substantial rate of adults with prediabetes and undiagnosed diabetes mellitus (DM), our aim was to perform haemoglobin A1c (HbA1c)-based screening in a cohort of Croatian adults and estimate the prevalence of prediabetes and undiagnosed DM according to American Diabetes Association criteria. MATERIALS AND METHODS: This multi-center, cross-sectional study performed in six Croatian hospitals included 5527 patients aged 40 to 70 years admitted to the Emergency Department or undergoing a primary care check-up. Haemoglobin A1c was measured from leftover whole blood samples using the enzymatic method on either Alinity c or Architect c-series analyser (Abbott Laboratories, Chicago, USA). Haemoglobin A1c between 39-47 mmol/mol was classified as prediabetes, while ≥ 48 mmol/mol as undiagnosed DM. RESULTS: After exclusion of 435 patients with known DM, the final cohort included 5092 patients (median age 57; 56% males). A total of 882 (17.3%) patients had HbA1c values between 39 and 47 mmol/mol. There were 214 (4.2%) patients with HbA1c ≥ 48 mmol/mol. Prediabetes prevalence ranged from 14.2% to 20.5%, while undiagnosed DM from 3.3% to 7.3%, with statistically significant differences among settings (P < 0.001). Age-stratified analysis showed that prediabetes and undiagnosed DM prevalence increase with age (P < 0.001), being 25.4% and 5.8%, respectively, in patients aged 60 to 70 years. CONCLUSION: Underlying impairment of glucose metabolism was identified in about one in five adults, with significant number of patients with already overt DM. These results should serve as a starting point for further steps directed towards promotion of preventive measures for DM in Croatia.

Knowledge and awareness of iodine intake - survey among Croatian women of reproductive age.

INTRODUCTION: Appropriate iodine intake is important for the entire population, especially in fertile women due to decisive role of thyroid hormones in normal foetal brain development. The aim of this study was to investigate knowledge on iodine role among Croatian women of reproductive age. MATERIALS AND METHODS: The survey was conducted among 378 women of reproductive age during May-September 2018. Data on age, education level, salt intake habits, knowledge of the iodine role and possible presence of thyroid disease were collected and results were presented as numbers or percentage of total number of participants. Comparison between groups was performed by Chi square test. RESULTS: Of 378 participants, 178 reported to be familiar with the iodine role in the body (P = 0.115). Significantly higher proportion of the younger woman and woman with lower degree of education weren't familiar with the iodine role (P < 0.001). More woman were introduced to consequences of insufficient than to excessive iodine intake (273 vs 213; P < 0.001). In addition, participants mainly weren't familiar with obligation of salt iodination (P < 0.001). Presence of thyroid disease was recorded in 75 subjects with higher prevalence in subjects 36-49 years (P < 0.001). Presence of thyroid disease was not associated with knowledge on iodine role on health. CONCLUSION: Women of reproductive age are not completely aware of the consequences of excessive iodine intake. Thus, further education focusing on more sensitive groups such as woman of younger age should be considered in order to preserve their and their children's health.