Trial reportFamily practice2015
Can HbA1c replace OGTT for the diagnosis of diabetes mellitus among Chinese patients with impaired fasting glucose?
Trial report in Family practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03617757 (Determinants of Progression From Impaired Fasting Glucose to Diabetes Mellitus Among Chinese - a 3-year Follow up Study), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Determinants of Progression From Impaired Fasting Glucose to Diabetes Mellitus Among Chinese - a 3-year Follow up Study
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Prevalence of Type 2 Diabetes Mellitus in Adult Population of Pakistan: A Meta-Analysis of Prospective Cross-Sectional Surveys.Annals of global health · 2020Pooled it
- Trial
- Pre-transplant HbA1c and risk of diabetes mellitus after kidney transplantation: a single center retrospective analysis.Journal of nephrology · 2023Article
- Practice Patterns in the Acceptance of Medically Complex Living Kidney Donors with Obesity, Hypertension, Family History of Kidney Disease, or Donor-Recipient Age Discrepancy.Avicenna journal of medicine · 2021Article
- Beyond Asian-Specific Cutoffs: Gender Effects on the Predictability of Body Mass Index, Waist Circumference, and Waist Circumference to Height Ratio on Hemoglobin A1c.Journal of racial and ethnic health disparities · 2021Article
- Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity.Endocrinology and metabolism (Seoul, Korea) · 2020Article
- Article
- The Compatibility of Hemoglobin A1c with Oral Glucose Tolerance Test and Fasting Plasma Glucose.Sisli Etfal Hastanesi tip bulteni · 2020Article
- Not performing an OGTT results in underdiagnosis, inadequate risk assessment and probable cost increases of (pre)diabetes in Han Chinese over 40 years: a population-based prospective cohort study.Endocrine connections · 2018Article
- Validation of a nomogram for predicting regression from impaired fasting glucose to normoglycaemia to facilitate clinical decision making.Family practice · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHbA1c ≥ 6.5% has been recommended as a diagnostic criterion for the detection of diabetes mellitus (DM) since 2010 because of its convenience, stability and significant correlation with diabetic complications. Nevertheless, the accuracy of HbA1c compared to glucose-based diagnostic criteria varies among subjects of different ethnicity and risk profile.
objectivesThis study aimed to evaluate the accuracy of HbA1c for diagnosing DM compared to the diagnosis by oral glucose tolerance test (OGTT) and the optimal HbA1c level to diagnose DM in primary care Chinese patients with impaired fasting glucose (IFG).
methodsA cross-sectional study was carried out in three public primary care clinics in Hong Kong. About 1128 Chinese adults with IFG (i.e. FG level between 5.6 and 6.9 mmol/l in the past 18 months) were recruited to receive paired OGTT and HbA1c tests. Sensitivities and specificities of HbA1c at different threshold levels for predicting DM compared to the diagnosis by OGTT were evaluated. A receiver operating characteristic (ROC) curve was used to determine the optimal cut-off level.
resultsAmong the 1128 subjects (mean age 64.2±8.9 year, 48.8% male), 229 (20.3%) were diagnosed to have DM by OGTT. The sensitivity and specificity of HbA1c ≥6.5% were 33.2% and 93.5%, respectively, for predicting DM diagnosed by OGTT. The area under the ROC curve was 0.770, indicating HbA1c had fair discriminatory power. The optimal cut-off threshold of HbA1c was 6.3% for discriminating DM from non-DM, with sensitivity and specificity of 56.3% and 85.5%, respectively. HbA1c ≥ 5.6% has the highest sensitivity and negative predictive value of 96.1% and 94.5%, respectively.
conclusionsHbA1c ≥ 6.5% is highly specific in identifying people with DM, but it may miss the majority (66.8%) of the DM cases. An HbA1c threshold of <5.6% is more appropriate to be used for the exclusion of DM. OGTT should be performed for the confirmation of DM among Chinese patients with IFG who have an HbA1c between 5.6% and 6.4%.
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