Early Detection of Risk for Type 2 Diabetes and Sugary Drinks Intake ^†

In New Zealand, the incidence of type 2 diabetes (T2D) is increasing in Pacific youth. A high intake of sugary drinks has been proposed as an explanation. Glycated haemoglobin A_1c (HbA_1c) is a widely used biomarker which reflects the person’s average blood glucose over the last 2–3 months. Point-of-care testing (POCT) of HbA_1c have been used in the management of individuals with diabetes but POCT HbA_1c is not recommended for the diagnosis of diabetes. The aim of this study was to compare the performance of a POCT HbA_1c test measured by the Afinion^TM AS100 Analyser with a reference venous blood measure and investigate associations between HbA_1c and daily sugary drinks intake among Pacific youth. A sub-sample of 94 girls and 96 boys aged 15y, was drawn from the Pacific Islands Families Study. HbA_1c was measured with the Afinion using a capillary finger- prick sample. The measurement was repeated one year later and concurrently a venous blood sample was analysed by boronate affinity chromatography. An online validated qualitative food frequency questionnaire was applied. Bland-Altman, paired t-test, and correlation coefficient compared the two POCT and reference measures. There was a moderate to strong correlation between the two POCT measures between years (r = 0.55, 95% CI 0.44, 0.65, p < 0.001) with a mean difference 0.14 ± 2.18 (SD) mmol.mol⁻¹. For the same day analysis, the mean difference in capillary and venous measures was 0.54 mmol.mol⁻¹ (95% CI mean: 0.25, 0.83, p < 0.001) with ±1.96SD limits of agreement: 4.48, −3.40 mmol.mol⁻¹. Median daily sugary drinks intake was 2.12 servings (1.13, 3.64). There was no relationship between sugary drinks intakes and HbA_1c. The Afinion POCT test has the potential to identify those at early risk of elevated HbA_1c and inform dietary advice. The relationship of sugary drinks intake to T2D risk factors needs further investigation.