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Updated: Jun 4, 2026

A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
High-normal HbA1c is a strong predictor of type 2 diabetes in the general population
Enzo Bonora1, Stefan Kiechl, Agnes Mayr
1Section of Endocrinology and Metabolism, Department of Medicine, University of Verona, Verona,Italy. enzo.bonora@univr.it
Objective:
Glycosylated hemoglobin (HbA(1c)) recently has been recommended for the diagnosis of diabetes by the American Diabetes Association, but its value in the prediction of type 2 diabetes is poorly understood. In this study we evaluated how high-normal HbA(1c) levels predict type 2 diabetes.
Research Design And Methods:
We measured HbA(1c) in 919 Caucasian subjects, aged 40-79 years, and recorded new cases of type 2 diabetes in the following 15 years. Diabetes was diagnosed with HbA(1c).
Results:
Subjects were stratified according to baseline HbA(1c) (<5.0, 5.00-5.49 [reference], 5.50-5.99, and 6.00-6.49%). Sex- and age-adjusted hazard ratios (95% CI) for type 2 diabetes were 1.11 (0.30-4.41), 1.00, 3.79 (1.79-8.06), and 12.50 (5.51-28.34), respectively. Results did not change after adjusting for several putative confounding factors and were confirmed when models with updated variables were used.
Conclusions:
HbA(1c) is an independent risk factor for type 2 diabetes. Subjects with high-normal levels of HbA(1c) deserve particular attention because they have a strong risk of developing diabetes.
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