Comparison of Hemoglobin A1c with Fasting and 2-h Plasma Glucose Tests for Diagnosis of Diabetes and Prediabetes among High-risk South Indians.
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Cites background from "Comparison of Hemoglobin A1c with F..."
...[6,7] Moreover, measuring HbA1c is expensive as compared to FPG assessments and standardization of measurement techniques and laboratories are poorly practiced across the country.[8] Also, in several countries including India, HbA1c demonstrated inadequate predictive accuracy in the diagnosis of diabetes, there is no consensus on a suitable cut-off point of HbA1c for diagnosis of diabetes in this high-risk population....
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...Infections in diabetes • Several factors have been implicated for infections in diabetes, of which, altered immunity is the most predominant one.[4,8] Other predisposing factors...
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...6% excludes prediabetes/diabetes status.[8]...
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References
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"Comparison of Hemoglobin A1c with F..." refers result in this paper
...Methods: This diagnostic accuracy study, conducted at a tertiary care teaching hospital located in South India, enrolled 332 adults at high risk for diabetes and subjected them to testing (FPG, 2 hPG, and HbA1c) twice at 2–3 weeks interval....
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...Further larger community-based studies from different parts of India, involving participants at different levels of risk for diabetes and employing tests twice, would be needed for ascertaining the role of HbA1c vis‑à‑vis plasma glucose tests....
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...[7] The frequency of diabetes and prediabetes in the present study was expectedly two to three times of their reported prevalence in earlier population-based studies from India,[6,7,9,22,23] because of higher metabolic risk among participants....
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367 citations
"Comparison of Hemoglobin A1c with F..." refers background or methods or result in this paper
...[2] Variability of FPG, 2-h plasma glucose post-75 g oral glucose load (2 hPG) and HbA1c over a short duration[10] has most probably not been studied in the Indian population so far....
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...[10] This may be due to the differences in race and risk profile of participants for diabetes in the present study versus that of Selvin et al.[10]...
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...[5,10] HbA1c was the least variable of three diagnostic tests for diabetes over a short duration of 2–3 weeks in the present study, similar to earlier studies.[5,10] Thus, unlike PG tests, HbA1c may have the advantage of achieving diabetes diagnosis after single testing, provided the assay well-standardized and test is utilized judiciously considering its nonreliability in certain situations....
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...[10] This may be due to the differences in race and risk profile of participants for diabetes in the present study versus that of Selvin et al.[10] Optimal HbA1c cutoff determined for diabetes diagnosis in the present study matched with ADA recommended cutoff of 6.5% and had high accuracy of ≈ 95%....
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...Differences were calculated as visit 1 minus visit 2, the within-person coefficients of variation were calculated as the square root of the within‐subject variance divided by the mean squared and their confidence intervals were obtained using bootstrap methods.[10]...
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320 citations
"Comparison of Hemoglobin A1c with F..." refers background or result in this paper
...[5,10] HbA1c was the least variable of three diagnostic tests for diabetes over a short duration of 2–3 weeks in the present study, similar to earlier studies.[5,10] Thus, unlike PG tests, HbA1c may have the advantage of achieving diabetes diagnosis after single testing, provided the assay well-standardized and test is utilized judiciously considering its nonreliability in certain situations....
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...HbA1c, being a measure of average PG over prior 2–3 months, is a better marker of long-term hyperglycemia compared to FPG or 2 hPG tested twice and is better associated with chronic complications of diabetes,[5] especially microvascular ones....
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...HbA1c offers some advantages over PG tests.[5] It is more convenient to perform (can be done at any time of day and no need for overnight fasting and glucose challenge); and hence better compliance with testing, has lowest variability (unaffected by stress, acute illness and changes in diet and physical activity just before testing) and the values would not be affected by delayed analysis of blood samples after collection, unlike PG tests....
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...2 hPG has been found to be the most variable and HbA1c to be the least variable among diagnostic tests for diabetes in the previous studies.[5,10] HbA1c was the least variable of three diagnostic tests for diabetes over a short duration of 2–3 weeks in the present study, similar to earlier studies....
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