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[Comparative study of glycosylated hemoglobin with oral glucose tolerance test in a selected population]
G B Viñes1, M Roubicek, A González Sanguineti
1Hospital Privado de Comunidad, Mar del Plata, Argentina. statti@infovia.com.ar
Insights
Glycosylated hemoglobin (HbA1c) offers a reliable alternative for diagnosing and screening diabetes mellitus. This method shows high sensitivity and specificity, correlating well with glucose levels for effective diabetes management.
Area of Science:
- Endocrinology
- Clinical Chemistry
- Diagnostic Medicine
Background:
- Diabetes mellitus diagnosis relies on glucose measurements, which can be challenging for screening.
- Glycosylated hemoglobin (HbA1c) reflects long-term glycemic control.
Purpose of the Study:
- To evaluate the utility of HbA1c as an alternative diagnostic and screening tool for diabetes mellitus.
- To compare HbA1c measurements with oral glucose tolerance tests (OGTT).
Main Methods:
- Analysis of 405 consecutive OGTTs and simultaneous HbA1c measurements.
- HbA1c measured using the 2000 DC immunoassay.
- Comparison with World Health Organization (WHO) and American Diabetes Association (ADA) diagnostic criteria.
Main Results:
- Good correlation observed between HbA1c and fasting or 2-hour glucose levels.
- HbA1c at 5.4% demonstrated high sensitivity (0.96) for screening at-risk populations.
- HbA1c levels of 6.0-6.3% showed high specificity (0.94-0.97) for diabetes diagnosis.
Conclusions:
- HbA1c measurement is a valid alternative for diabetes diagnosis and screening in at-risk individuals.
- Accurate HbA1c assays can effectively complement or replace traditional glucose testing.
- This approach aids in identifying and confirming diabetes mellitus in diverse patient groups.
Abstract:
A series of 405 consecutive oral glucose tolerance tests was analyzed in comparison with simultaneous glycosylated hemoglobin (HbA1c) measurements, in order to ascertain the possible utility of HbA1c as an alternative method for diagnosis and screening in populations suspected or at increased risk of presenting diabetes mellitus. The study group consisted of 158 male and 247 nonpregnant female patients aged 3 to 84 years (median 61.5 and 56 years, respectively) referred by their physicians for diagnostic purposes. Tolerance test was performed according to usual methods and HbA1c was measured with the 2000 DC immunoassay. Results showed a good correlation between HbA1c and fasting or 2 hour glucose levels. Using WHO diagnostic criteria, HbA1c maximal normal level of 5.4% showed a sensitivity of 0.96 in distinguishing between non-diabetics and those at increased risk, for screening purposes. With HbA1c levels of 6.0 or 6.3%, specificity for a correct diagnosis of diabetes was high (0.94 or 0.97) making this a suitable level for diagnostic confirmation. With the new ADA criteria for fasting plasma glucose, the results were similar. We suggest that HbA1c measurement with highly accurate methods might be considered a valid alternative for diagnosis and screening in populations suspected or at increased risk of presenting diabetes mellitus.