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Community-based approach to screen Black men for type 2 diabetes

Researchers have found that community barbershops are promising venues for screening Black men for type 2 diabetes and identifying those with undiagnosed disease, so treatment could begin earlier. Many people with type 2 diabetes do not know they have it, and minority groups have disproportionately high rates of undiagnosed diabetes. Timely diagnosis is important so that people with the disease receive appropriate treatment to control their blood glucose (sugar) levels and prevent life-threatening complications. Black men with diabetes have high rates of diabetes complications and are less likely to live into their seventies than men from other racial/ethnic groups. However, type 2 diabetes diagnosis is often delayed, particularly in Black men who do not receive regular primary care and thus may not ever be screened or tested for the disease. Thus, it is important to identify approaches for timely diagnosis of type 2 diabetes in this population to improve their health.

In a recent study, researchers examined whether a community-based approach using barbershops owned by Black individuals could identify Black men with undiagnosed type 2 diabetes. The researchers asked 895 Black men at 8 different barbershops in Brooklyn, New York, if they would be willing to be screened for type 2 diabetes using a type of hemoglobin A1c (HbA1c) test that can be administered onsite and that gives results in 5 minutes. About one-third of the men agreed to be screened and 290 were successfully tested. Testing showed that 26 men (9 percent) had undiagnosed type 2 diabetes and 82 (28 percent) had prediabetes—a condition of intermediate blood glucose levels that is a known risk factor for later developing type 2 diabetes. The researchers gave the men with diabetes or prediabetes follow-up information, including the names of local primary care clinics. The most common reason participants gave for declining screening was because they already knew their health status or were under a doctor’s care. Some limitations of the study include the fact that it took place in only one city, so it is unknown if similar participation rates would be observed in other areas of the country. In addition, although the point-of-care HbA1c test used is very convenient and fairly accurate, follow-up laboratory tests, which were not included in the study, would be needed to confirm the initial diagnoses.

Community-based approaches at barbershops have been used successfully for addressing other health conditions, such as identifying and treating Black men with high blood pressure. Therefore, adopting strategies like the one in this study to help identify people with undiagnosed type 2 diabetes who would benefit from treatment—particularly if paired with approaches for lowering other barriers to obtaining proven therapies—hold promise to yield progress toward U.S. health equity.

Osorio M, Ravenell JE, Sevick MA,…Lee DC. Community-based hemoglobin A1c testing in barbershops to identify Black men with undiagnosed diabetes. JAMA Intern Med 180: 596-597, 2020.

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