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.