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Optimal HbA1c cutoff for detecting diabetic retinopathy
Nam H Cho1, Tae Hyuk Kim, Se Joon Woo
1Department of Preventive Medicine, Ajou University School of Medicine, Suwon, South Korea.
Acta Diabetologica
|January 29, 2013
Summary
Hemoglobin A1c (HbA1c) levels effectively detect diabetic retinopathy. A threshold of 48 mmol/mol (6.5%) accurately identifies retinopathy, supporting HbA1c
Area of Science:
- Endocrinology
- Ophthalmology
- Clinical Diagnostics
Background:
- High glucose levels are linked to diabetic retinopathy, a leading cause of blindness.
- Glycated hemoglobin (HbA1c) reflects long-term glucose control.
- The diagnostic accuracy of HbA1c for retinopathy requires updated data.
Purpose of the Study:
- To update data on the relationship between HbA1c and diabetic retinopathy.
- To evaluate the diagnostic accuracy of proposed HbA1c cutoffs for detecting diabetic retinopathy.
Main Methods:
- Cross-sectional study of 3,403 adults (Ansung Cohort Study 2009-2010).
- Retinopathy assessed via fundus photography and graded using the International Clinical Diabetic Retinopathy Disease Severity Scale.
- HbA1c measured using high-performance liquid chromatography.
Main Results:
- Retinopathy prevalence was low below HbA1c 48-51 mmol/mol (6.5-6.8%).
- Optimal HbA1c cutoffs for any retinopathy: 49 mmol/mol (6.6%); for moderate/severe retinopathy: 52 mmol/mol (6.9%).
- The American Diabetes Association's proposed threshold of 48 mmol/mol (6.5%) showed comparable accuracy for detecting any and moderate/severe retinopathy.
Conclusions:
- The HbA1c threshold of 48 mmol/mol (6.5%) effectively detects diabetic retinopathy.
- HbA1c is a valuable tool for diagnosing diabetes and screening for diabetic retinopathy.
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