Identifying a Potential Screening Tool for Prediabetes: The Association of Hemoglobin A1c and a Test of Physical Fitness

INTRODUCTION: The purpose of this study is to correlate HbA1c values with data points in the Air Force Physical Fitness Test (AFPT) in our active duty population.

MATERIALS AND METHODS: This study looks at 489 active duty U.S. Air Force members who performed the AFPT within 1 month of study participation at Nellis Air Force Base, Las Vegas, NV from July 2011 to August 2013. This cross-sectional study included a demographic survey, examination of AFPT results, and lab values, including Hemoglobin A1c and fasting lipid panel.

RESULTS: A statistically significant association was detected between the prevalence of prediabetes or diabetes (HbA1c≥5.7%) and fitness level (16.98% in Unsatisfactory, 12.12% in Satisfactory, and 6.72% in Excellent; p = 0.0352). Prediabetes and diabetes were more prevalent among subjects who had an exemption for the AFPT (25.67% vs 7.23%; p < 0.0001). Among known risk factors, the prevalence of prediabetes and diabetes was higher with subjects that had an abdominal circumference >35 inches (19.78% vs 7.56%; p = 0.0004), a body mass index of ≥30 (20.0% vs 8.35%, p = 0.0026), and among individuals with a first degree relative with diabetes (15.70% vs. 8.15%; p = 0.0164). The prevalence of prediabetes and diabetes was lower in subjects with HDL ≥40 than HDL <40 (22.22% vs 8.40%; p = 0.0073).

CONCLUSIONS: Exemptions taken on the AFPT, increased abdominal circumference, and elevated body mass index are strongly associated with prediabetes in this military population. HbA1c could be a screening tool for these at-risk personnel to identify diabetes in its early stages.