| HbA1c for the diagnosis of diabetes mellitus in a developing country. A position article. | |
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MedLine Citation:
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PMID: 20637376 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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An Expert Committee of the American Diabetes Association and the European Association for the Study of Diabetes recommended a move to the use of HbA1c level to diagnose diabetes mellitus. Diagnosis should be made if the A1c level is > or = 6.5%. HbA1c provides a reliable measure of chronic glycemia, correlates well with the risk of long-term diabetes complications and technical limitations for standardization have been overcome in laboratories of the U.S. and Europe. The objective of this paper is to analyze critically the advantages and disadvantages of the use of HbA1c as a diagnostic method of diabetes in a developing country. The lack of a universal threshold for the diagnosis of diabetes, the cost of the test and the absence of the standardization network in the majority of the countries are major arguments for not including HbA1c as diagnostic criteria of diabetes. HbA1c diagnostic criteria has a low sensitivity. As a result, there is a lack of agreement between the HbA1c criteria with the other diagnostic methods that lead into significant variations in the number of affected cases. In addition, sensitivity and specificity vary among ethnic groups. No study has compared the diagnostic properties of the HbA1c in Latin America. In conclusion, the logistic limitations that exist in a large proportion of developing countries and the unsolved uncertainties that exist for the definition of the A1c criterion are strong arguments against the inclusion of HbA1c among the diagnostic criteria of diabetes. |
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Authors:
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Francisco J Gomez-Perez; Carlos A Aguilar-Salinas; Paloma Almeda-Valdes; Daniel Cuevas-Ramos; Israel Lerman Garber; Juan A Rull |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of medical research Volume: 41 ISSN: 1873-5487 ISO Abbreviation: Arch. Med. Res. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-07-19 Completed Date: 2010-11-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9312706 Medline TA: Arch Med Res Country: United States |
Other Details:
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Languages: eng Pagination: 302-8 Citation Subset: IM |
Copyright Information:
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Copyright 2010 IMSS. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubiran, Mexico, D.F., Mexico. gomezperezfco@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Developing Countries Diabetes Mellitus / diagnosis* Hemoglobin A, Glycosylated / analysis* Humans |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobin A, Glycosylated |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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