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Hemoglobin A1c testing alone does not sufficiently identify patients with prediabetes

Sophie Bersoux1, Curtiss B Cook, Qing Wu

  • 1Division of Community Internal Medicine, Mayo Clinic, Scottsdale, AZ 85259, USA.

American Journal of Clinical Pathology
|April 20, 2011
PubMed

Insights

Hemoglobin A1c (HbA1c) testing alone may miss many individuals with prediabetes. Many patients with impaired glucose levels had HbA1c results below diagnostic thresholds, highlighting the need for comprehensive screening.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Diabetes Mellitus Research

Background:

  • The diagnostic utility of Hemoglobin A1c (HbA1c) for diabetes and prediabetes remains a subject of ongoing debate.
  • Prediabetes affects a significant portion of the population, increasing the risk of developing type 2 diabetes.

Purpose of the Study:

  • To evaluate the prevalence of elevated HbA1c levels within a prediabetes patient cohort.
  • To determine the effectiveness of HbA1c testing in identifying individuals eligible for diabetes prevention programs.

Main Methods:

  • Analysis of oral glucose tolerance tests (OGTT) and HbA1c levels in patients entering a diabetes prevention program.
  • Calculation of the percentage of patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) falling within specific HbA1c ranges (6.0%-6.4% and 5.7%-6.4%).

Main Results:

  • The study included 242 patients (mean age 62 years, 64% women, 88% white).
  • 56.2% of patients had isolated IFG, and 37.2% had combined IFG and IGT.
  • Only 28.5% of patients had HbA1c values between 6.0% and 6.4%, while 65.3% had values between 5.7% and 6.4%.

Conclusions:

  • Relying solely on HbA1c testing may fail to identify a substantial number of individuals with prediabetes who could benefit from intervention.
  • Comprehensive diagnostic approaches, including OGTT, are crucial for accurate prediabetes identification and enrollment in prevention programs.

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