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A1C to detect diabetes in healthy adults: when should we recheck?
Osamu Takahashi1, Andrew J Farmer, Takuro Shimbo
1Department of Primary Health Care, University of Oxford, Oxford, U.K. otakahas@luke.or.jp
Objective:
To evaluate the optimal interval for rechecking A1C levels below the diagnostic threshold of 6.5% for healthy adults.
Research Design And Methods:
This was a retrospective cohort study. Participants were 16,313 apparently healthy Japanese adults not taking glucose-lowering medications at baseline. Annual A1C measures from 2005 to 2008 at the Center for Preventive Medicine, a community teaching hospital in Japan, estimated cumulative incidence of diabetes.
Results:
Mean age (+/-SD) of participants was 49.7 +/- 12.3 years, and 53% were male. Mean A1C at baseline was 5.4 +/- 0.5%. At 3 years, for those with A1C at baseline of <5.0%, 5.0-5.4%, 5.5-5.9%, and 6.0-6.4%, cumulative incidence (95% CI) was 0.05% (0.001-0.3), 0.05% (0.01-0.11), 1.2% (0.9-1.6), and 20% (18-23), respectively.
Conclusions:
In those with an A1C <6.0%, rescreening at intervals shorter than 3 years identifies few individuals (approximately
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