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Haemoglobin A1c as a screening tool for type 2 diabetes and prediabetes in populations of Swedish and Middle-East ancestry

Hellgren, Margareta; Hjörleifsdottir Steiner, Kristin and Bennet, Louise LU (2017) In Primary Care Diabetes
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.

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author
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Diabetes mellitus, Diagnose, Ethnicity (no 8), HbA1c, Prediabetes, Screening
in
Primary Care Diabetes
publisher
Elsevier
external identifiers
  • scopus:85019946765
ISSN
1751-9918
DOI
10.1016/j.pcd.2017.04.008
language
English
LU publication?
no
id
18aa4f78-025e-4ea8-95af-7959183e2f6d
date added to LUP
2017-06-16 12:22:51
date last changed
2017-06-18 03:00:11
@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},
  keyword      = {Diabetes mellitus,Diagnose,Ethnicity (no 8),HbA1c,Prediabetes,Screening},
  language     = {eng},
  month        = {05},
  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},
  year         = {2017},
}