Dataset Information

Are the same clinical risk factors relevant for incident diabetes defined by treatment, fasting plasma glucose, and HbA1c?

ABSTRACT:

Objective

To compare incidences and risk factors for diabetes using seven definitions, with combinations of pharmacological treatment, fasting plasma glucose (FPG) ?7.0 mmol/L, and HbA(1c) ?6.5%.

Research design and methods

Participants aged 30-65 years from the Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort were followed for 9 years.

Results

More men had incident diabetes as defined by FPG ?7.0 mmol/L and/or treatment than by HbA(1c) ?6.5% and/or treatment: 7.5% (140/1,867) and 5.3% (99/1,874), respectively (P < 0.009); for women incidences were similar: 3.2% (63/1,958) and 3.4% (66/1,954). Known risk factors predicted diabetes for almost all definitions. Among those with incident diabetes by FPG alone versus HbA(1c) alone, there were more men (78 vs. 35%), case patients were 8 years younger, and fewer were alcohol abstainers (12 vs. 35%) (all P < 0.005). A diabetes risk score discriminated well between those with and without incident diabetes for all definitions.

Conclusions

In men, FPG definitions yielded more incident cases of diabetes than HbA(1c) definitions, in contrast with women. An FPG-derived risk score remained relevant for HbA(1c)-defined diabetes.

SUBMITTER: Balkau B

PROVIDER: S-EPMC3064057 | biostudies-literature | 2011 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Are the same clinical risk factors relevant for incident diabetes defined by treatment, fasting plasma glucose, and HbA1c?

Balkau Beverley B Soulimane Soraya S Lange Céline C Gautier Alain A Tichet Jean J Vol Sylviane S

Diabetes care 20110223 4

<h4>Objective</h4>To compare incidences and risk factors for diabetes using seven definitions, with combinations of pharmacological treatment, fasting plasma glucose (FPG) ≥7.0 mmol/L, and HbA(1c) ≥6.5%.<h4>Research design and methods</h4>Participants aged 30-65 years from the Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort were followed for 9 years.<h4>Results</h4>More men had incident diabetes as defined by FPG ≥7.0 mmol/L and/or treatment than by HbA(1c) ≥ ...[more]

PMID: 21346181

Similar Datasets

Project description:The prevalence of diabetes in Singapore is high. Screening to facilitate early detection and intervention has been shown to be cost-effective. Current clinical practice guidelines in Singapore recommend screening with fasting plasma glucose (FPG), followed by an oral glucose tolerance test (OGTT) in those with FPG 6.1-6.9?mmol/L. Glycated haemoglobin A1c (HbA1c) has robust stability at ambient temperature, and can be performed on non-fasted capillary blood samples, making it an attractive potential alternative for screening. However, limitations of HbA1c include differential performance in different races, and its performance as a screening test has not been well characterized in Asian populations. This study compares HbA1c and FPG as diabetes screening modalities in 3540 community-dwelling Singapore residents of Chinese, Malay and Indian race to detect diabetes mellitus diagnosed based on blood glucose (FPG???7.0?mmol/L, 2?hr OGTT???11.1?mmol/L). The area under the receiver-operating-characteristic curve (AUC) was higher for FPG compared to HbA1c in the overall population and age, race and age-race strata, but these differences were not statistically significant. HbA1c >?=?7.0% identified 95% of individuals with diabetes mellitus, and the remainder had impaired glucose tolerance (IGT). HbA1c cut-off at 6.1% had better sensitivity (0.825) to FPG at 6.1?mmol/L. The positive predictive value of HbA1c at 6.1% was 40-50% in different age-race combinations with a negative predictive value of about 98%. If follow-up screening with FPG is used, a lower cut-off at 5.6?mmol/L is appropriate in identifying people with pre-diabetes, as about 85% of people with HbA1c 6.1-6.9% and FPG 5.6-6.9?mmol/L had IFG/IGT or diabetes in the study sample. HbA1c is an appropriate alternative to FPG as a first-step screening test, and the combination of Hba1c?>?=?6.1% and FPG?>?=?5.6?mmol/L would improve the identification of individuals with diabetes mellitus and prediabetes.

Dataset Information

Are the same clinical risk factors relevant for incident diabetes defined by treatment, fasting plasma glucose, and HbA1c?

Objective

Research design and methods

Results

Conclusions

Publications

Are the same clinical risk factors relevant for incident diabetes defined by treatment, fasting plasma glucose, and HbA1c?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets