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HbA1c, fasting plasma glucose and the prediction of diabetes: Inter99, AusDiab and D.E.S.I.R.
Diabetes Research and Clinical Practice, 06/29/2012
Clinical Article
Soulimane S et al. – HbA1c and fasting plasma glucose (FPG) change–points predicting incident diabetes did not always exist, differed across studies, when available were generally lower than current criteria with wide confidence intervals. Using jointly HbA1c≥5.7% and/or FPG≥5.6mmol/l as a criterion for the risk of incident diabetes is appropriate.
Methods- Data are Danish (Inter99), Australian (AusDiab) and French (D.E.S.I.R.), with respectively 4930, 6012 and 3784 non–diabetic participants.
- Diabetes incidences at 5 years for Inter99 and AusDiab and at 6 years for D.E.S.I.R. were 2.3%, 3.1% and 2.4% respectively and incidences increased with baseline HbA1c and FPG.
- As HbA1c distributions differed between cohorts, HbA1c was standardized on D.E.S.I.R. data.
- Change–points where diabetes incidence increased were identified for HbA1c (%) after standardization: 5.1 (4.9–5.6) (Inter99), 5.4 (5.1–5.6) (AusDiab), 5.3 (5.1–5.7) (D.E.S.I.R.); for FPG change–points (mmol/l) were 5.1 (…–6.1) (Inter99), 5.5 (5.2–5.8) (AusDiab), no change–point for D.E.S.I.R.
- Using current diabetes risk criteria HbA1c≥5.7% and/or FPG≥5.6mmol/l to screen for diabetes provided high sensitivity (over 89%) and positive predictive values: 4.3%, 6.9%, and 5.9% respectively.
