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Hemoglobin A1c levels in a diabetes detection program.

J V Santiago, J E Davis, F Fisher

    The Journal of Clinical Endocrinology and Metabolism
    |September 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

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    Hemoglobin A1c (HbA1c) testing is less sensitive for diagnosing mild diabetes than oral glucose tolerance tests (OGTT). Elevated HbA1c typically indicates significantly higher 2-hour OGTT glucose levels, suggesting more severe hyperglycemia.

    Area of Science:

    • Endocrinology
    • Metabolic Disorders
    • Clinical Chemistry

    Background:

    • The oral glucose tolerance test (OGTT) is a standard diagnostic tool for diabetes.
    • Hemoglobin A1c (HbA1c) provides a measure of long-term glycemic control.
    • Discrepancies between OGTT and HbA1c can impact diabetes diagnosis and management.

    Purpose of the Study:

    • To compare Hemoglobin A1c (HbA1c) concentrations with plasma glucose responses during an oral glucose tolerance test (OGTT).
    • To evaluate the diagnostic utility of HbA1c in subjects with postprandial hyperglycemia.

    Main Methods:

    • Sixty-three subjects with pre-existing postprandial hyperglycemia were enrolled.
    • HbA1c levels were measured and correlated with 1-hour and 2-hour plasma glucose levels from an OGTT.

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  • Subjects were categorized based on OGTT results: diabetic-like, indeterminate, or normal.

    • Main Results:

    • HbA1c showed strong correlations with 1-hour (r=0.776) and 2-hour (r=0.860) OGTT glucose levels.
    • Of 21 subjects with diabetic-like OGTT responses, only 10 had elevated HbA1c.
    • Subjects with elevated HbA1c consistently had 2-hour OGTT glucose levels above 228 mg/100 ml.

    Conclusions:

    • Approximately half of individuals diagnosed with mild or chemical diabetes via OGTT do not have elevated HbA1c.
    • Elevated HbA1c is a reliable indicator of significantly high 2-hour OGTT glucose levels (above 228 mg/100 ml).
    • HbA1c may underestimate glycemic control in some individuals diagnosed with diabetes by OGTT alone.