Estimating the Rates of Undiagnosed Prediabetes and Diabetes among People Experiencing Homelessness

Background The rising prevalence of type 2 diabetes (T2D) in Canada poses a significant health challenge. Despite the convenience of screening for diabetes with glycated hemoglobin concentration, people experiencing homelessness (PEH) often face barriers to accessing diabetes screening, potentially leading to underdiagnosis. This study aims to assess the prevalence of undiagnosed diabetes among PEH in Calgary, Alberta, contributing insights for planning healthcare services and public health initiatives. Methods Four screening clinics were held, and participants were recruited through posters and word of mouth. Participants underwent point-of-care glycated hemoglobin (A1C) testing using the Siemens DCA Vantage point-of-care analyzer. Descriptive statistics were used to identify the proportions of prediabetes and diabetes, while CanRisk survey scores were used to identify the pre-test probability of diabetes. Results The mean age of participants (n=102) was 47.6 years, and the self-reported causes of homelessness amongst the participants were diverse: housing and financial issues (n=53), interpersonal and family issues (n=35), and health or corrections-related factors (n=27). The average A1C was 5.60% (SD=0.57), with five values in the diabetes range and twelve in the prediabetes range, for a total of 17 participants who were found to have previously undiagnosed dysglycemia. Conclusion The high rate of undiagnosed prediabetes and diabetes among people experiencing homelessness, reflects at least what is already found in the general population in Canada. More resources are required to reduce the barriers to screening for diabetes among this population.