Kimberley Aboriginal Services Council Inc Kimberley Aboriginal Medical Services Council Research

Investigation of the role of HbA1c in diabetes screening protocols in remote Aboriginal communities

Type 2 diabetes and its associated complications are a significant health problem facing Aboriginal and/or Torres Strait Islander peoples in Australia. While early diagnosis and treatment of diabetes leads to improved outcomes this condition remains undiagnosed in up to 50% of people. Current screening methods are failing to detect people with diabetes in northern Australia. In December 2009 the American Diabetes Association updated their criteria for diagnosing diabetes to include glycated haemoglobin A (HbA1c) testing. Currently the use of HbA1c to diagnose diabetes is not part of the Australian guidelines

We will determine if it is feasible to translate existing findings regarding the potential utility of HbA1c as a diagnostic tool for diabetes, into everyday remote Aboriginal and Torres Strait Islander health service practice. We will be adding HbA1c to existing screening and assessing the benefit of this addition in terms of increased number of diagnoses, cost of testing and cost potentially saved from repeat visits if HbA1c were to be used instead of some or all of the existing somewhat complex screening pathway.

The aims of this project are:

  • To describe current pathways for, and outcomes of, screening for diabetes in  Aboriginal and/or Torres Strait Islander peoples in the Kimberley region.
  • To evaluate the efficacy of incorporating HbA1c measurement into screening for diabetes in Aboriginal and/or Torres Strait Islander peoples living in the Kimberley region.
  • To test the accuracy / reliability of point-of-care HbA1c compared with laboratory testing as a screening tool for type 2 diabetes in a real world remote setting.
  • To determine the prevalence of risk factors for kidney, retinal and macrovascular disease in Aboriginal and Torres Strait Islander Australians with newly diagnosed type 2 diabetes.
  • To increase research interest and capacity among health staff, particularly Aboriginal and/or Torres Strait Islander staff, and to build skills in remote Aboriginal and Torres Strait Islander health service research.

To ensure that the project findings are generalisable to the broader remote Aboriginal and Torres Strait Islander primary health care environment, it will be carried out in a range of health care services across the Kimberley.

This project is a collaboration between The Rural Clinical School of WA, KAMSC and WA Country Health Services – Kimberley.


Julia V Marley, May S Oh, Nyssa N Hadgraft N, Sally Singleton,David Atkinson. Cross-sectional comparison of point-of-care with laboratory HbA1c in detecting diabetes in real-world remote Aboriginal settings. BMJ Open 2015; 5:e006277.


  • Assoc Prof Julia Marley
  • Dr Kim Isaacs
  • Dr May Sian Oh
  • Dr Sally Singleton
  • Assoc Prof David Atkinson
  • Nyssa Hadgraft

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