G6PD Deficiency: Delayed Diabetes Diagnosis in Black & Asian Men
Genetic Condition May Delay Diabetes Diagnosis in Black and South Asian Men, Increasing Complication Risk
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EXETER, UK – A newly discovered link between a common genetic condition, G6PD deficiency, and inaccurate diabetes testing could be leading to delayed diagnoses and increased health risks for thousands of men of Black and South Asian descent in the UK – and possibly millions globally. Research from the University of Exeter, in collaboration with Queen Mary University of London, reveals that the standard HbA1c blood test can be misleading in individuals with this deficiency, masking elevated blood sugar levels.
The study found that approximately 1 in 7 Black men and 1 in 63 South Asian men in the UK carry the G6PD deficiency gene variant. Men with this deficiency are diagnosed with type 2 diabetes, on average, four years later than those without the variant, yet fewer than 1 in 50 are even aware they have the condition.
How G6PD Deficiency Impacts Diabetes Testing
G6PD deficiency itself doesn’t cause diabetes. Though, it interferes with the HbA1c test, the globally recognized standard for diagnosing and monitoring diabetes (used in 136 countries, including the UK). The test measures average blood sugar levels over the past 2-3 months. In individuals with G6PD deficiency, the test can artificially show lower blood sugar levels than are actually present. This leads to misdiagnosis or delayed diagnosis, hindering timely treatment and increasing the risk of serious health complications.
“Our findings highlight the urgent need for changes to testing practices to tackle health inequalities,” says Professor Inês Barroso of the University of Exeter. “Doctors and health policy makers need to be aware that the HbA1c test may not be accurate for people with G6PD deficiency and routine G6PD screening could help identify those at risk. Addressing this issue is not only crucial for medicine, but for health equity.”
Prevalence and Risk
G6PD deficiency affects over 400 million people worldwide, especially those of African, Asian, Middle Eastern, and Mediterranean ancestry. While frequently enough asymptomatic, the condition’s impact on diabetes diagnosis is significant. The research demonstrates a 37% higher risk of developing microvascular complications – damage to the eyes, kidneys, and nerves - in diabetic men with G6PD deficiency compared to those without it.
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This study underscores a critical, and frequently enough overlooked, aspect of precision medicine: the importance of considering genetic variations when interpreting standard diagnostic tests. The HbA1c test is a cornerstone of diabetes care, but its reliance on a single metric fails to account for biological differences that can considerably alter results. The disproportionate impact on Black and South Asian communities highlights existing health disparities and the need for culturally sensitive and genetically informed healthcare practices. The call for routine G6PD screening is a vital step towards achieving health equity and preventing avoidable complications. Further research is needed to explore alternative diagnostic methods for individuals with G6PD deficiency and to understand the full scope of this issue globally.
Current Testing Practices & Future Initiatives
The World Health Organization recommends G6PD deficiency screening in at-risk populations, but this is not consistently implemented in the UK or many other countries. Dr. Veline L’Esperance, a GP and Senior Clinical Research Fellow at QMUL, emphasizes the urgency of the situation: “These findings are deeply concerning because they show how a widely used diagnostic tool may be failing communities that are already disproportionately affected by type 2 diabetes. Too many people are being left undiagnosed untill it is too late to prevent serious complications.”
QMUL is launching “Black Health legacy,” a large-scale initiative aimed at improving health outcomes within the black community, in part by addressing these diagnostic challenges.
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