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Title: | A1C for screening and diagnosis of type 2 diabetes in routine clinical practice. | Authors: | O'Dea K.;Shaw J.E.;Lu Z.X.;Walker K.Z.;Sikaris K.A. | Institution: | (Lu, Sikaris) Melbourne Pathology Services, Melbourne, VIC, Australia (Lu) Department of Medicine, Monash Medical Centre, Monash University, Melbourne, VIC, Australia (Walker) Department of Nutrition and Dietetics, Monash University, Melbourne, VIC, Australia (Walker) Preventative Health Unit, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia (O'Dea) Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia (Shaw) Clinical Diabetes and Epidemiology Unit, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia | Issue Date: | 11-Oct-2012 | Copyright year: | 2010 | Publisher: | American Diabetes Association Inc. (1701 North Beauregard St., Alexandria VA 22311, United States) | Place of publication: | United States | Publication information: | Diabetes Care. 33 (4) (pp 817-819), 2010. Date of Publication: April 2010. | Abstract: | OBJECTIVE - To evaluate A1C for screening and diagnosis of undiagnosed type 2 diabetes defined by oral glucose tolerance testing in clinical and general populations. RESEARCH DESIGN AND METHODS - A1C cut offs (<=5.5% to rule out diabetes; >=7.0% to rule in diabetes) were derived from a clinical group (Melbourne Pathology [MP] group: n = 2,494; undiagnosed diabetes 34.6%) and then evaluated in a population-based sample (AusDiab group: n = 6,015; undiagnosed diabetes 4.6%). RESULTS - For diabetes in the MP and AusDiab groups, A1C at 5.5% gave sensitivities of 98.7 and 83.5%, while A1C at 7.0% gave specificities of 98.2 and 100%, respectively. Many (61.9-69.3%) with impaired A1C (5.6-6.9%) in both populations had abnormal glucose status. CONCLUSIONS - A1C <=5.5% and >=7.0% predicts absence or presence of type 2 diabetes, respectively, while at A1C 6.5-6.9% diabetes is highly probable in clinical and population settings. A high proportion of people with impaired A1C have abnormal glucose status requiring follow-up. © 2010 by the American Diabetes Association. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.2337/dc09-1763 | PubMed URL: | 20067965 [http://www.ncbi.nlm.nih.gov/pubmed/?term=20067965] | ISSN: | 0149-5992 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/31067 | Type: | Article | Subjects: | controlled study diagnostic value glucose blood level hemoglobin determination human impaired glucose tolerance/di [Diagnosis] impaired glucose tolerance/et [Etiology] major clinical study *non insulin dependent diabetes mellitus/di [Diagnosis] *non insulin dependent diabetes mellitus/ep [Epidemiology] oral glucose tolerance test screening sensitivity and specificity glucose/ec [Endogenous Compound] *hemoglobin A1c/ec [Endogenous Compound] Australia article screening sensitivity and specificity major clinical study impaired glucose tolerance / diagnosis / etiology human hemoglobin determination article oral glucose tolerance test diagnostic value controlled study Australia *non insulin dependent diabetes mellitus / *diagnosis / *epidemiology glucose blood level |
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