Fasting Plasma Glucose and the HbA1c Are Not Optimal Screening Modalities for the Diagnosis of New Diabetes in Previously Undiagnosed Asian Indian Community Participants

Ethnicity & Disease
Rosaley Prakaschandra, Datshanna Prakesh Naidoo

Abstract

There is no definitive consensus on the screening algorithm in high-risk communities for diabetes. The aims of our study were to determine the prevalence of undiagnosed diabetes in a high-risk community using the oral glucose tolerance test (OGTT), as well as determine the value of anthropometric measurements and other measures of glycemia in the detection of diabetes. All participants from the Phoenix Lifestyle project without known diabetes, and who had undergone an OGTT were selected for study. Anthropometric measurements were collected according to accepted guidelines. Diabetes was diagnosed if fasting plasma glucose (FPG) ≥7.0 mmol/l, if 2-hour plasma glucose level during OGTT was ≥ 11.0 mmol/l, or if HbA1c ≥ 6.5%. The prevalence of newly diagnosed diabetes was 14.3% (11.7 % age standardized) (women=15.4%; men=11.8%). The prevalence rates were underestimated using FPG criteria, but overestimated when using the HbA1c. The AUC (area under the receiver-operator characteristics curve) was highest for FPG (.879), HbA1c (.855), then anthropometry measures (BMI=.621; waist circumference=.627). For diabetes, at levels >6.3, the discriminant ability (DA) of HbA1c was highest (79%), while a cut-point of ≥5.5mmol/l for FPG yielded a ...Continue Reading

Citations

Jul 24, 2020·Indian Journal of Endocrinology and Metabolism·Rajeev ChawlaUNKNOWN RSSDI-ESI Consensus Group
Apr 24, 2020·Journal of Nutrition and Metabolism·Keddagoda Gamage Piyumi WasanaKamani Ayoma Perera Wijewardana Jayatilaka

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