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Hemoglobin A1c in predicting progression to diabetes.
Tomoko Nakagami1, Naoko Tajima, Toshihide Oizumi
1Diabetes Centre, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. nakagami@dmc.twmu.ac.jp
Diabetes Research and Clinical Practice
|December 1, 2009
Summary
Hemoglobin A1c (HbA1c) shows similar predictive value for diabetes mellitus (DM) risk as fasting plasma glucose (FPG). HbA1c offers higher specificity and may be a more practical screening tool for DM in the future.
Area of Science:
- Endocrinology
- Preventive Medicine
- Clinical Diagnostics
Background:
- Diabetes Mellitus (DM) diagnosis relies on specific glycemic thresholds.
- Fasting Plasma Glucose (FPG) is a standard diagnostic marker, but its practicality in large-scale screening is debated.
- Hemoglobin A1c (HbA1c) offers an alternative measure of glycemic control.
Purpose of the Study:
- To compare the predictive value of HbA1c versus FPG for incident DM over a 5-year period.
- To evaluate the practicality and efficiency of HbA1c as a screening tool for DM compared to FPG.
Main Methods:
- Prospective cohort study involving 1189 non-diabetic adults (aged 35-89) from the Funagata Study.
- Assessed 5-year incidence of DM using WHO criteria.
- Analyzed predictive performance using odds ratios, receiver operating characteristic curves, sensitivity, and specificity.
Main Results:
- A total of 57 participants (4.8%) developed DM within 5 years.
- HbA1c and FPG demonstrated comparable odds ratios for DM risk (3.49 vs. 3.40) and AUC values (0.785 vs. 0.786).
- HbA1c at 5.3% showed higher specificity (87.8%) than FPG at 5.56 mmol/l (82.5%) with a lower proportion of individuals exceeding the cutoff (14.3% vs. 19.6%).
Conclusions:
- HbA1c is a valuable tool for evaluating DM risk, comparable to FPG.
- HbA1c presents higher specificity and may be more practical and efficient for selecting individuals for intervention in DM screening programs.
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