Diabetes Risk Assessment, A1C Measurement, and Goal Achievement of Standards of Care in Adults Experiencing Homelessness

Abstract

Purpose The purpose of this study was to explore diabetes in adults experiencing homelessness by evaluating diabetes risk, A1C measurement, and achievement of the goals of the American Diabetes Association (ADA) Standards of Medical Care in Diabetes. Methods Project Homeless Connect Omaha is a 1-day health and social services event for adults who are homeless. The event seeks to meet immediate needs, identify potential future needs, and provide a connection with community resources for further follow-up for these adults. Health professions students and faculty from the university where the event is held volunteer their time to provide these services. Risk assessment for type 2 diabetes, A1C measurement, and evaluation of the ADA Standards of Medical Care were available for participants of this event. Results Of the 478 participants who completed a risk assessment for diabetes, 91 underwent rapid A1C testing. Four participants at the diabetes station (4%) were newly identified as having diabetes with elevated A1C, and 32% of the participants had elevated A1C levels demonstrating prediabetes. Twelve individuals reported being previously diagnosed with diabetes, and of those, 50% had A1C levels between 7.3% and >13% (56 to 119 mmol/mol). Participants whose A1Cs classified them as having prediabetes or diabetes (n = 40) completed an evaluation of standards of medical care goals. Participants identified eye, foot, and dental examinations; lipid management; and urine protein screening as some of the areas in which the standards were not yet achieved. Conclusion Adults experiencing homelessness have a significant need for diabetes screening and management. Diabetes educators can provide education to equip adults with the ability to effectively manage their illness and prevent complications.