A1C and Diabetes Diagnosis: The Rancho Bernardo Study
نویسندگان
چکیده
OBJECTIVE To examine the sensitivity and specificity of A1C as a diagnostic test for type 2 diabetes in older adults. RESEARCH DESIGN AND METHODS Cross-sectional study of community-dwelling adults without known diabetes who had an oral glucose tolerance test and A1C measured on the same day. RESULTS Mean age of the 2,107 participants was 69.4 +/- 11.1 years; 43% were men. Based on the American Diabetes Association (ADA) criteria, 198 had previously undiagnosed type 2 diabetes. The sensitivity/specificity of A1C cut point of 6.5% was 44/79%. Results were similar in age- and sex-stratified analyses. Given the A1C cut point of 6.5%, 85% of participants were classified as nondiabetic by ADA criteria. CONCLUSIONS The limited sensitivity of the A1C test may result in delayed diagnosis of type 2 diabetes, while the strict use of ADA criteria may fail to identify a high proportion of individuals with diabetes by A1C > or =6.5% or retinopathy.
منابع مشابه
Response to Comment on: Boronat et al. Differences in Cardiovascular Risk Profile of Diabetic Subjects Discordantly Classified by Diagnostic Criteria Based on Glycated Hemoglobin and Oral Glucose Tolerance Test. Diabetes Care 2010;33:2671–2673
We appreciate the efforts of Kramer and Araneta (1) to investigate whether our findings are reproducible in the Rancho Bernardo cohort. In apparent contrast to our results (2), they observed that subjects with diabetic oral glucose tolerance test (OGTT) but A1C ,6.5% displayed a more unfavorable cardiovascular risk profile than subjects with A1C $6.5% (1). However, as noted by the authors, grou...
متن کاملComment on: Boronat et al. Differences in Cardiovascular Risk Profile of Diabetic Subjects Discordantly Classified by Diagnostic Criteria Based on Glycated Hemoglobin and Oral Glucose Tolerance Test. Diabetes Care 2010;33:2671–2673
We read with interest the article by Boronat et al. (1). In that article, individuals with discordant diabetes status by A1C and oral glucose tolerance test (OGTT) had their cardiovascular risk profile evaluated. Those who fulfilled the A1C-based criterion presented greater measures of BMI and waist circumference and lower values for HDL cholesterol than individuals with diabetic OGTT but A1C,6...
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