Derivation & validation of glycosylated haemoglobin (HbA 1c ) cut-off value as a diagnostic test for type 2 diabetes in south Indian population.
Alladi Mohan,S. Aparna Reddy,Alok Sachan,K.V.S. Sarma,D Prabath Kumar,Mahesh V. Panchagnula,Pvln Srinivasa Rao,B Siddhartha Kumar,P Krishnaprasanthi +8 more
TLDR
HbA1c >6.3 per cent appears to be the optimal cut-off value for the diagnosis of type 2 diabetes applicable to the ethnic population of Rayalaseema area of Andhra Pradesh state in south India.Abstract:
Background & Objectives: Glycosylated haemoglobin (HbA 1c ) has been in use for more than a decade, as a diagnostic test for type 2 diabetes. Validity of HbA 1c needs to be established in the ethnic population in which it is intended to be used. The objective of this study was to derive and validate a HbA 1c cut-off value for the diagnosis of type 2 diabetes in the ethnic population of Rayalaseema area of south India. Methods: In this cross-sectional study, consecutive patients suspected to have type 2 diabetes underwent fasting plasma glucose (FPG) and 2 h post-load plasma glucose (2 h-PG) measurements after a 75 g glucose load and HbA 1c estimation. They were classified as having diabetes as per the American Diabetes Association criteria [(FPG ≥7 mmol/l (≥126 mg/dl) and/or 2 h-PG ≥11.1 mmol/l (≥200 mg/dl)]. In the training data set (n = 342), optimum cut-off value of HbA 1c for defining type 2 diabetes was derived by receiver-operator characteristic (ROC) curve method using oral glucose tolerance test results as gold standard. This cut-off was validated in a validation data set (n = 341). Results: On applying HbA 1c cut-off value of >6.3 per cent (45 mmol/mol) to the training data set,sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for diagnosing type 2 diabetes were calculated to be 90.6, 85.2, 80.8 and 93.0 per cent, respectively. When the same cut-off value was applied to the validation data set, sensitivity, specificity, PPV and NPV were 88.8 , 81.9, 74.0 and 92.7 per cent, respectively, although the latter were consistently smaller than the proportions for the training data set, the differences being not significant. Interpretation & conclusions: HbA 1c >6.3 per cent (45 mmol/mol) appears to be the optimal cut-off value for the diagnosis of type 2 diabetes applicable to the ethnic population of Rayalaseema area of Andhra Pradesh state in south India.read more
Citations
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Comparison of Hemoglobin A1c with Fasting and 2-h Plasma Glucose Tests for Diagnosis of Diabetes and Prediabetes among High-risk South Indians.
Pedapati Radhakrishna,Kolar Vishwanath Vinod,Akkilagunta Sujiv,Rathinam Palamalai Swaminathan +3 more
TL;DR: HbA1c ≥6.5% is a convenient and reliable alternative to plasma glucose tests to diagnose diabetes among high-risk South Indians and 0.6% had 100% negative predictive value to exclude prediabetes/diabetes.
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Choice of criterion used in the receiver operating characteristic analysis.
TL;DR: It is believed that in selecting the criterion used to derive the most appropriate test cut-off value in the receiver operating characteristic (ROC) curve analysis, the author should also consider other important contributing factors.
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Intermediate hyperglycaemia and 10-year mortality in resource-constrained settings: the PERU MIGRANT Study.
Maria Lazo-Porras,Maria Lazo-Porras,A. Ruiz-Alejos,A. Ruiz-Alejos,J. Jaime Miranda,Rodrigo M. Carrillo-Larco,Rodrigo M. Carrillo-Larco,Robert H. Gilman,Liam Smeeth,Antonio Bernabe-Ortiz +9 more
TL;DR: To determine whether intermediate hyperglycaemia, defined by fasting plasma glucose and HbA1c criteria, is associated with mortality in a 10‐year cohort of people in a Latin American country, a cohort study is conducted.
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Effect of Two-Only-Meal Frequency and Exercise on HbA1C Outcomes, Weight, and Anti-Diabetic Medication in Type 2 Diabetes in a Popular Lifestyle Change Campaign in Maharashtra, Compared to Conventional Clinical Management: A Quasi-Experimental Multicenter Study in Maharashtra
Shyam V Ashtekar,Pradeep R Deshmukh,Nitin Ghaisas,Chandrashekhar Ashtekar,Sameeran Upasani,Madhuri Kirloskar,Ajit Bhaskar Kumthekar,Mrunalini Kelkar,Ratna S Ashtekar,Parag Vijay Misar,Vikas Ratnaparakhe,Manjiri P. Dhamangaonkar,R S Kiwalkar,Sanjay Gandhi,Jagdish D Powar +14 more
TL;DR: In this paper , the effect of 2-only-daily-meals with exercise (2-OMEX) for its effect on HbA1c, oral hypoglycaemic agents (OHA) usage, body-weight among type-2-diabetes (T2DM) subjects, compared with conventional management was evaluated.
References
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Journal ArticleDOI
Utility of Glycated Hemoglobin in Diagnosing Type 2 Diabetes Mellitus: A Community-Based Study
Padala Ravi Kumar,Anil Bhansali,M. Ravikiran,Shobhit Bhansali,Pinaki Dutta,J.S. Thakur,Naresh Sachdeva,Sanjay Kumar Bhadada,Rama Walia +8 more
TL;DR: A HbA1c cut point of 6.1% has an optimal sensitivity and specificity of 81% and can be used as a screening test, and a cut pointof 6.5% has optimal specificity of 88% for diagnosis of diabetes.
Journal ArticleDOI
A1C Cut Points to Define Various Glucose Intolerance Groups in Asian Indians
Viswanathan Mohan,Venkataraman Vijayachandrika,Kuppan Gokulakrishnan,Ranjit Mohan Anjana,Anbazhagan Ganesan,Mary Beth Weber,K.M. Venkat Narayan +6 more
TL;DR: In Asian Indians, A1C cut points of 6.1 and 6.4% defined diabetes by 2-h postload plasma glucose or FPG criteria, respectively, while a value of 5.6% optimally identified IGT or IFG but was <70% accurate.
Journal ArticleDOI
A1C: does one size fit all?
TL;DR: A “high glycator–low glycator” hypothesis is proposed to explain how apparently equivalent glycemic control could result in differing A1C values, based on the observation that while most individuals in a population with a given mean blood glucose will have A 1C within a fairly narrow expected range, there are subsets who have a consistently higher or consistently lower value.
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HbA1c of 6.5% to diagnose diabetes mellitus -- does it work for us? -- the Bellville South Africa study
TL;DR: A cut off of 6.5% (48 mmol/mol) is a good diagnostic tool with its high specificity; however the low sensitivity limits its use, which emphasizes the need for evidenced based values to be established in various population groups.
Journal ArticleDOI
HbA1c values for defining diabetes and impaired fasting glucose in Asian Indians
Manisha Nair,Dorairaj Prabhakaran,K.M. Venkat Narayan,Rashmi Sinha,Ramakrishnan Lakshmy,Niveditha Devasenapathy,Carrie R. Daniel,Ruby Gupta,Preethi Sara George,Aleyamma Mathew,Nikhil Tandon,K. Srinath Reddy +11 more
TL;DR: In this study population from north and south regions of India, the HbA(1c) cut-point that defines NDD was much lower than that proposed by an international expert committee and the American Diabetes Association (≥6.8%) and was slightly lower than the ≥5.7% for high risk proposed, but accuracy was less than 70%.