Optimal Hemoglobin A1c Levels for Screening of Diabetes and Prediabetes in the Japanese Population.
TLDR
HbA1c may be inadequate as a screening tool for prediabetes, with areas under the curve of 0.918 and 0.714 proving that HbA 1c was a good test to identify diabetes and predi diabetes.Abstract:
The aim of this study was to evaluate the utility of hemoglobin A1c (HbA1c) to identify individuals with diabetes and prediabetes in the Japanese population. A total of 1372 individuals without known diabetes were selected for this study. A 75 g oral glucose tolerance test (OGTT) was used to diagnose diabetes and prediabetes. The ability of HbA1c to detect diabetes and prediabetes was investigated using receiver operating characteristic (ROC) analysis. The kappa (κ) coefficient was used to test the agreement between HbA1c categorization and OGTT-based diagnosis. ROC analysis demonstrated that HbA1c was a good test to identify diabetes and prediabetes, with areas under the curve of 0.918 and 0.714, respectively. Optimal HbA1c cutoffs for diagnosing diabetes and prediabetes were 6.0% (sensitivity 83.7%, specificity 87.6%) and 5.7% (sensitivity 60.6%, specificity 72.1%), respectively, although the cutoff for prediabetes showed low accuracy (67.6%) and a high false-negative rate (39.4%). Agreement between HbA1c categorization and OGTT-based diagnosis was low in diabetes (κ = 0.399) and prediabetes (κ = 0.324). In Japanese subjects, the HbA1c cutoff of 6.0% had appropriate sensitivity and specificity for diabetes screening, whereas the cutoff of 5.7% had modest sensitivity and specificity in identifying prediabetes. Thus, HbA1c may be inadequate as a screening tool for prediabetes.read more
Citations
More filters
Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Prediabetes as a toxic environment for the initiation of microvascular and macrovascular complications
TL;DR: The pathophysiologic defects underlying prediabetes include insulin resistance, β cell dysfunction, increased lipolysis, inflammation, suboptimal incretin effect, and possibly hepatic glucose overproduction.
Journal ArticleDOI
Visceral adiposity index (VAI), lipid accumulation product (LAP), and product of triglycerides and glucose (TyG) to discriminate prediabetes and diabetes.
Nayeon Ahn,Sebastian E. Baumeister,Ute Amann,Wolfgang Rathmann,Annette Peters,Cornelia Huth,Barbara Thorand,Christa Meisinger +7 more
TL;DR: TyG and LAP provide good discrimination of persons with prediabetes/diabetes in the general German population, according to the American Diabetes Association (ADA) criteria.
Journal ArticleDOI
Flow cytometric fingerprinting for microbial strain discrimination and physiological characterization.
TL;DR: The presented data demonstrate that flow cytometric fingerprinting is a sensitive and reproducible technique with the potential to be applied as a method for the dereplication of bacterial isolates.
Journal ArticleDOI
Screening for diabetes with HbA1c: Test performance of HbA1c compared to fasting plasma glucose among Chinese, Malay and Indian community residents in Singapore.
TL;DR: HbA1c is an appropriate alternative to FPG as a first-step screening test, and the combination of Hba1c and FPG would improve the identification of individuals with diabetes mellitus and prediabetes.
References
More filters
Journal ArticleDOI
The meaning and use of the area under a receiver operating characteristic (ROC) curve.
TL;DR: A representation and interpretation of the area under a receiver operating characteristic (ROC) curve obtained by the "rating" method, or by mathematical predictions based on patient characteristics, is presented and it is shown that in such a setting the area represents the probability that a randomly chosen diseased subject is (correctly) rated or ranked with greater suspicion than a random chosen non-diseased subject.
Journal ArticleDOI
Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030
TL;DR: Findings indicate that the "diabetes epidemic" will continue even if levels of obesity remain constant, and given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
Journal ArticleDOI
Diagnosis and Classification of Diabetes Mellitus
TL;DR: The chronic hyperglycemia of diabetes is associated with long-term damage, dys-function, and failure of differentorgans, especially the eyes, kidneys, nerves, heart, and blood vessels.
Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Standards of medical care in diabetes.
TL;DR: I would like to take issue with the use of the phrase “standards of medical care in diabetes,” which is used to describe diabetes care standards, in the recently updated and circulatedADA 2006 Clinical Practice Recommendations.