HbA1c for the diagnosis of diabetes mellitus in a developing country. A position article

Archives of Medical Research
Francisco J Gomez-PerezJuan A Rull

Abstract

An Expert Committee of the American Diabetes Association and the European Association for the Study of Diabetes recommended a move to the use of HbA1c level to diagnose diabetes mellitus. Diagnosis should be made if the A1c level is > or = 6.5%. HbA1c provides a reliable measure of chronic glycemia, correlates well with the risk of long-term diabetes complications and technical limitations for standardization have been overcome in laboratories of the U.S. and Europe. The objective of this paper is to analyze critically the advantages and disadvantages of the use of HbA1c as a diagnostic method of diabetes in a developing country. The lack of a universal threshold for the diagnosis of diabetes, the cost of the test and the absence of the standardization network in the majority of the countries are major arguments for not including HbA1c as diagnostic criteria of diabetes. HbA1c diagnostic criteria has a low sensitivity. As a result, there is a lack of agreement between the HbA1c criteria with the other diagnostic methods that lead into significant variations in the number of affected cases. In addition, sensitivity and specificity vary among ethnic groups. No study has compared the diagnostic properties of the HbA1c in Latin Ame...Continue Reading

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Citations

Feb 6, 2014·Journal of Diabetes and Metabolic Disorders·Akram AhangarpourBabadi Hajani Mehrangiz
Dec 19, 2015·Expert Review of Molecular Diagnostics·Weiping Jia
Dec 3, 2014·Clinica Chimica Acta; International Journal of Clinical Chemistry·Shu Hwang AngSook Mei Khor
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Mar 23, 2017·Diabetic Medicine : a Journal of the British Diabetic Association·H AftabD L Christensen

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