Screening life insurance applicants with hemoglobin A1c: a pilot study of cost-benefit

Hemogloblin A1c (HgbA1c) values are superior to those of random serum glucose, serum fructosamine, and urine glucose as a means of detecting carbohydrate intolerance. Further, HgbA1c values have been shown to correlate with mortality in a continuous fashion beginning at levels between 5.0% and 6.0%. Unfortunately, the expense of HgbA1c testing is considerably higher than that of routine serum chemistry testing. Diabetes is an increasingly common disorder clearly associated with mortality. Also, the current demographic trends towards increasing age and increasing prevalence of obesity underscore the value to underwriters of identifying carbohydrate intolerance.