Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
(2023) In Nature Medicine 29(11). p.2885-2901- Abstract
- Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the... (More)
- Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance. © 2023, The Author(s). (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/223cd9a3-f437-412c-9120-8c1a7d4f7e7b
- author
- Zhou, B. ; Giwercman, A. LU and Ezzati, Majid
- author collaboration
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Blood Glucose, Diabetes Mellitus, Fasting, Glucose, Glycated Hemoglobin, Humans, Prevalence, glucose, glycated hemoglobin, diabetes mellitus, fasting, glucose blood level, human, prevalence
- in
- Nature Medicine
- volume
- 29
- issue
- 11
- pages
- 17 pages
- publisher
- Nature Publishing Group
- external identifiers
-
- scopus:85176735771
- pmid:37946056
- ISSN
- 1078-8956
- DOI
- 10.1038/s41591-023-02610-2
- language
- English
- LU publication?
- yes
- id
- 223cd9a3-f437-412c-9120-8c1a7d4f7e7b
- date added to LUP
- 2024-01-16 14:36:55
- date last changed
- 2024-01-17 03:00:56
@article{223cd9a3-f437-412c-9120-8c1a7d4f7e7b,
abstract = {{Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance. © 2023, The Author(s).}},
author = {{Zhou, B. and Giwercman, A. and Ezzati, Majid}},
issn = {{1078-8956}},
keywords = {{Blood Glucose; Diabetes Mellitus; Fasting; Glucose; Glycated Hemoglobin; Humans; Prevalence; glucose; glycated hemoglobin; diabetes mellitus; fasting; glucose blood level; human; prevalence}},
language = {{eng}},
number = {{11}},
pages = {{2885--2901}},
publisher = {{Nature Publishing Group}},
series = {{Nature Medicine}},
title = {{Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c}},
url = {{http://dx.doi.org/10.1038/s41591-023-02610-2}},
doi = {{10.1038/s41591-023-02610-2}},
volume = {{29}},
year = {{2023}},
}