Haemoglobin A1c as a screening tool for type 2 diabetes and prediabetes in populations of Swedish and Middle-East ancestry
(2017) In Primary Care Diabetes 11(4). p.337-343- Abstract
Aims: To explore and compare sensitivity and specificity for HbA1c ≥48. mmol/mol as a predictor for type 2 diabetes mellitus (T2DM) in two populations with different ethnicity and to examine the predictive value of two levels of HbA1c (≥42. mmol/mol, ≥39. mmol/mol) for prediabetes in these populations. Methods: Four cohorts were examined with an oral glucose tolerance test. (1) The MEDIM Study (n = 1991 individuals of Swedish and Iraqi ancestry); (2) The Skaraborg Project (n = 1327 individuals of Swedish ancestry); (3) The 4-D study (n = 424 individuals of Swedish, Iraqi and Turkish ancestry); (4) The Flemingsberg study (n = 212 participants of Turkish ancestry). Results: HbA1c ≥48. mmol/mol had a sensitivity for T2DM of 31% and 25%... (More)
Aims: To explore and compare sensitivity and specificity for HbA1c ≥48. mmol/mol as a predictor for type 2 diabetes mellitus (T2DM) in two populations with different ethnicity and to examine the predictive value of two levels of HbA1c (≥42. mmol/mol, ≥39. mmol/mol) for prediabetes in these populations. Methods: Four cohorts were examined with an oral glucose tolerance test. (1) The MEDIM Study (n = 1991 individuals of Swedish and Iraqi ancestry); (2) The Skaraborg Project (n = 1327 individuals of Swedish ancestry); (3) The 4-D study (n = 424 individuals of Swedish, Iraqi and Turkish ancestry); (4) The Flemingsberg study (n = 212 participants of Turkish ancestry). Results: HbA1c ≥48. mmol/mol had a sensitivity for T2DM of 31% and 25% respectively in individuals of Middle-East and Swedish ancestry. The positive and negative predictive value was high in both populations (70.3, 96.4 and 96.2, 97.6 respectively). Using HbA1c ≥42. mmol/mol and ≥39. mmol/mol as a predictor for prediabetes gave a sensitivity of 17% and 36% in individuals of Middle-East and 15% and 34% in individuals of Swedish ancestry. Conclusions: Even if HbA1c ≥48. mmol/mol is a valuable diagnostic tool, it is a blunt and insensitive tool for screening and would exclude most people with T2DM, independent of ancestry and age. HbA1c is an inefficient way to detect individuals with prediabetes.
(Less)
- author
- Hellgren, Margareta ; Hjörleifsdottir Steiner, Kristin and Bennet, Louise LU
- organization
- publishing date
- 2017-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Diabetes mellitus, Diagnose, Ethnicity (no 8), HbA1c, Prediabetes, Screening
- in
- Primary Care Diabetes
- volume
- 11
- issue
- 4
- pages
- 337 - 343
- publisher
- Elsevier
- external identifiers
-
- pmid:28545842
- scopus:85019946765
- ISSN
- 1751-9918
- DOI
- 10.1016/j.pcd.2017.04.008
- project
- The MEDIM project
- Nationwide research collaboration in family medicine and type 2 diabetes - Swedish Primary Care Diabetes (SPACE)
- language
- English
- LU publication?
- no
- id
- 18aa4f78-025e-4ea8-95af-7959183e2f6d
- date added to LUP
- 2017-06-16 12:22:51
- date last changed
- 2024-08-04 23:31:08
@article{18aa4f78-025e-4ea8-95af-7959183e2f6d, abstract = {{<p>Aims: To explore and compare sensitivity and specificity for HbA1c ≥48. mmol/mol as a predictor for type 2 diabetes mellitus (T2DM) in two populations with different ethnicity and to examine the predictive value of two levels of HbA1c (≥42. mmol/mol, ≥39. mmol/mol) for prediabetes in these populations. Methods: Four cohorts were examined with an oral glucose tolerance test. (1) The MEDIM Study (n = 1991 individuals of Swedish and Iraqi ancestry); (2) The Skaraborg Project (n = 1327 individuals of Swedish ancestry); (3) The 4-D study (n = 424 individuals of Swedish, Iraqi and Turkish ancestry); (4) The Flemingsberg study (n = 212 participants of Turkish ancestry). Results: HbA1c ≥48. mmol/mol had a sensitivity for T2DM of 31% and 25% respectively in individuals of Middle-East and Swedish ancestry. The positive and negative predictive value was high in both populations (70.3, 96.4 and 96.2, 97.6 respectively). Using HbA1c ≥42. mmol/mol and ≥39. mmol/mol as a predictor for prediabetes gave a sensitivity of 17% and 36% in individuals of Middle-East and 15% and 34% in individuals of Swedish ancestry. Conclusions: Even if HbA1c ≥48. mmol/mol is a valuable diagnostic tool, it is a blunt and insensitive tool for screening and would exclude most people with T2DM, independent of ancestry and age. HbA1c is an inefficient way to detect individuals with prediabetes.</p>}}, author = {{Hellgren, Margareta and Hjörleifsdottir Steiner, Kristin and Bennet, Louise}}, issn = {{1751-9918}}, keywords = {{Diabetes mellitus; Diagnose; Ethnicity (no 8); HbA1c; Prediabetes; Screening}}, language = {{eng}}, number = {{4}}, pages = {{337--343}}, publisher = {{Elsevier}}, series = {{Primary Care Diabetes}}, title = {{Haemoglobin A1c as a screening tool for type 2 diabetes and prediabetes in populations of Swedish and Middle-East ancestry}}, url = {{http://dx.doi.org/10.1016/j.pcd.2017.04.008}}, doi = {{10.1016/j.pcd.2017.04.008}}, volume = {{11}}, year = {{2017}}, }