| Insufficient sensitivity of hemoglobin A(₁C) determination in diagnosis or screening of early diabetic states. | |
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MedLine Citation:
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PMID: 20723948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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An International Expert Committee made recommendations for using the hemoglobin A(₁C) (A1C) assay as the preferred method for the diagnosis of diabetes in nonpregnant individuals. A concentration of at least 6.5% was considered as diagnostic. It is the aim of this study to compare the sensitivity of A1C with that of plasma glucose concentrations in subjects with early diabetes or impaired glucose tolerance (IGT). We chose 2 groups of subjects who had A1C not exceeding 6.4%. The first group of 89 subjects had family histories of diabetes (MODY or type 2 diabetes mellitus) and had oral glucose tolerance test (OGTT) and A1C determinations. They included 36 subjects with diabetes or IGT and 53 with normal OGTT. The second group of 58 subjects was screened for diabetes in our Diabetes Clinic by fasting plasma glucose, 2-hour plasma glucose, or OGTT and A1C; and similar comparisons were made. Subjects with diabetes or IGT, including those with fasting hyperglycemia, had A1C ranging from 5.0% to 6.4% (mean, 5.8%). The subjects with normal OGTT had A1C of 4.2% to 6.3% (mean, 5.4%), or 5.5% for the 2 groups. The A1C may be in the normal range in subjects with diabetes or IGT, including those with fasting hyperglycemia. Approximately one third of subjects with early diabetes and IGT have A1C less than 5.7%, the cut point that the American Diabetes Association recommends as indicating the onset of risk of developing diabetes in the future. The results of our study are similar to those obtained by a large Dutch epidemiologic study. If our aim is to recognize early diabetic states to apply effective prophylactic procedures to prevent or delay progression to more severe diabetes, A1C is not sufficiently sensitive or reliable for diagnosis of diabetes or IGT. A combination of A1C and plasma glucose determinations, where necessary, is recommended for diagnosis or screening of diabetes or IGT. |
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Authors:
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Stefan S Fajans; William H Herman; Elif A Oral |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-08-17 |
Journal Detail:
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Title: Metabolism: clinical and experimental Volume: 60 ISSN: 1532-8600 ISO Abbreviation: Metab. Clin. Exp. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-07 Completed Date: 2011-01-06 Revised Date: 2012-01-04 |
Medline Journal Info:
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Nlm Unique ID: 0375267 Medline TA: Metabolism Country: United States |
Other Details:
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Languages: eng Pagination: 86-91 Citation Subset: IM |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan Health System, Ann Arbor, MI 48106, USA. sfajans@umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Blood Glucose / analysis Child Diabetes Mellitus / diagnosis* Early Diagnosis Female Glucose Tolerance Test Hemoglobin A, Glycosylated / analysis* Humans Male Middle Aged Sensitivity and Specificity |
| Grant Support | |
ID/Acronym/Agency:
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DK020572/DK/NIDDK NIH HHS; M-01-RR-00042/RR/NCRR NIH HHS; P60 DK020572-34/DK/NIDDK NIH HHS; R01 DK088114-02/DK/NIDDK NIH HHS; UL1 RR024986-05/RR/NCRR NIH HHS; UL1RR024986/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human |
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