ArticleDiabetes care2015
Detection of abnormal glucose tolerance in Africans is improved by combining A1C with fasting glucose: the Africans in America Study.
Article in Diabetes care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed.
- Improved Detection of Abnormal Glucose Tolerance in Africans: The Value of Combining Hemoglobin ADiabetes care · 2020Trial
- Type 2 diabetes-associated gut microbial composition and short chain fatty acids differ across the epidemiologic transition in African origin populations.Gut microbes reports · 2027Article
- African immigrants with type 2 diabetes present with three physiologic subtypes: implications for screening, diagnosis and treatment.BMJ open diabetes research & care · 2026Article
- Improved detection of decreased glucose handling capacities via continuous glucose monitoring-derived indices.Communications medicine · 2025Article
- Can the level of HbABMC ophthalmology · 2022Article
- Combining HbAEClinicalMedicine · 2022Article
- Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study.BMJ open diabetes research & care · 2021Observational
- HbAPreventing chronic disease · 2021Article
- Prediabetes and long-term outcomes in patients with three-vessel coronary artery disease: A large single-center cohort study.Journal of diabetes investigation · 2021Observational
- Association between carriers of the G allele of the + 45T> G variant of the ADIPOQ gene (Heliyon · 2021Article
- Performance of diabetes screening tests: an evaluation study of Iranian diabetes screening program.Diabetology & metabolic syndrome · 2021Article
- Review
- Pitfalls of HbA1c in the Diagnosis of Diabetes.The Journal of clinical endocrinology and metabolism · 2020Article
- Review of methods for detecting glycemic disorders.Diabetes research and clinical practice · 2020Review
- Stress Measured by Allostatic Load Varies by Reason for Immigration, Age at Immigration, and Number of Children: The Africans in America Study.International journal of environmental research and public health · 2020Article
- Body adiposity measured by bioelectrical impedance is an alternative to dual-energy x-ray absorptiometry in black Africans: The Africans in America Study.Nutrition (Burbank, Los Angeles County, Calif.) · 2020Article
- Limitations of hemoglobin ACanadian family physician Medecin de famille canadien · 2020Article
- Hemoglobinopathies and Hemoglobin A1c in Diabetes Mellitus.Journal of diabetes science and technology · 2020Article
- Article
- Hypothesis: Role of Reduced Hepatic Insulin Clearance in the Pathogenesis of Type 2 Diabetes.Diabetes · 2019Article
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Authors and funding
8 authors.
Funding
Abstract
objectiveAbnormal glucose tolerance is rising in sub-Saharan Africa. Hemoglobin A1c by itself and in combination with fasting plasma glucose (FPG) is used to diagnose abnormal glucose tolerance. The diagnostic ability of A1C in Africans with heterozygous variant hemoglobin, such as sickle cell trait or hemoglobin C trait, has not been rigorously evaluated. In U.S.-based Africans, we determined by hemoglobin status the sensitivities of 1) FPG ≥5.6 mmol/L, 2) A1C ≥ 5.7% (39 mmol/mol), and 3) FPG combined with A1C (FPG ≥5.6 mmol/L and/or A1C ≥5.7% [39 mmol/mol]) for the detection of abnormal glucose tolerance. RESEARCH DESIGN AND
methodsAn oral glucose tolerance test (OGTT) was performed in 216 African immigrants (68% male, age 37 ± 10 years [mean ± SD], range 20-64 years). Abnormal glucose tolerance was defined as 2-h glucose ≥7.8 mmol/L.
resultsVariant hemoglobin was identified in 21% (46 of 216). Abnormal glucose tolerance occurred in 33% (72 of 216). When determining abnormal glucose tolerance from the OGTT (2-h glucose ≥7.8 mmol/L), sensitivities of FPG for the total, normal, and variant hemoglobin groups were 32%, 32%, and 33%, respectively. Sensitivities for A1C were 53%, 54%, and 47%. For FPG and A1C combined, sensitivities were 64%, 63%, and 67%. Sensitivities for FPG and A1C and the combination did not vary by hemoglobin status (all P > 0.6). For the entire cohort, sensitivity was higher for A1C than FPG and for both tests combined than for either test alone (all P values ≤ 0.01).
conclusionsNo significant difference in sensitivity of A1C by variant hemoglobin status was detected. For the diagnosis of abnormal glucose tolerance in Africans, the sensitivity of A1C combined with FPG is significantly superior to either test alone.
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