Year: 2016
Type: article
Abstract: Background: Various cut-offs for fasting (FBP)and 2-hour plasma glucose (2-hr PG) post oral glucose test (oGTT) have been proposed. More recently, it has been recommended that glycated haemoglobin (HbA1c) replace FBG and the oGTT. Objective: To compare the usefulness of fasting glucose alone, and HbA1c with the World Health Organisation (WHO) recommended fasting and 2-hr post oral glucose tolerance test glucose for use as screening tests for Type 2 diabetes mellitus. Research Design and Methods: Data were from 3,465 participants aged 35-74 years who were from the Diabetes, Heart and Health Survey that was carried out between 2002 and 2003. Participants underwent a 75g oGTT and HbA1c was determined by ion-exchange high-performance liquid chromatography. Results: Using the American Diabetes Association (ADA) fasting glucose cut-off of 7.0 mmol/L (126 mg/dL) alone would miss 46.9% of participants with diabetes diagnosed by oGTT criteria, comprising 57.1% of Europeans, 54.5% of Māori, 32.8% of Pacific and 57.1% of Asian people. Using an HbA1c only with cutoff of 48 mmol/mol (6.5%) would miss 59.2% of participants with WHO diagnosed diabetes, comprising 76.2% Europeans, 88.4% Māori, 50.0% Pacific, and 88.4% of Asian people. Compared to the oGTT and ADA fasting glucose criteria, an HbA1c of ≥ 48 mmol/mol had a sensitivity of 55.1% and a specificity of 96.7% (WHO), and 31.3% sensitivity and 99.5% specificity (ADA), respectively. Conclusions: Compared to the WHO oGTT criteria for diagnosing diabetes, fasting glucose alone and HbA1c are less sensitive, but more specific.
Authors: Metcalf, PA, Kyle, C, Kenealy, TW, Sundborn, G, Jackson, RT
Institutions: University of Auckland, Auckland City Hospital
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2968323677