ArticleBMC endocrine disorders2019
Preventing misdiagnosis of diabetes in the elderly: age-dependent HbA1c reference intervals derived from two population-based study cohorts.
Article in BMC endocrine disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- Clinical Practice Guideline: Shared Decision Making, Diagnostic Evaluation, and Pharmacotherapy in Type 2 Diabetes.Deutsches Arzteblatt international · 2023Guideline
- Accounting for Age-Related Increases in HbA1c More Accurately Quantifies Risk of Type 1 Diabetes Progression in Islet Autoantibody-Positive Adults.Diabetes care · 2026Observational
- Glycated hemoglobin and dynapenia in community- dwelling older people with and without diabetes: A cross-sectional study.Journal of diabetes and metabolic disorders · 2026Article
- Machine learning-based binary classification of elevated HbA1c (≥6.5 %) for risk assessment.Metabolism open · 2026Article
- Accounting for age-related increases in HbA1c more accurately quantifies risk of Type 1 Diabetes progression in islet autoantibody-positive adults.medRxiv : the preprint server for health sciences · 2026Article
- Analysis of the Relationship Between Glycated Hemoglobin and Echocardiographic Parameters in Patients Without Diabetes: A Retrospective Study.Journal of clinical medicine · 2025Article
- Assessing physicians' agreement and the completeness of the decision aid 'arriba Diabetes': a cross-sectional study.BMC primary care · 2025Article
- Narrative Review: Continuous Glucose Monitoring (CGM) in Older Adults with Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Review
- Associations between glycated haemoglobin and multi-modal imaging markers of early cardiac aging.GeroScience · 2025Observational
- The Impact of Age and Sex on Fasting Plasma Glucose and Glycated Haemoglobin (HbA1c) in the Non-diabetes Population.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Reference interval for glycated hemoglobin (HbA1c) in non-pregnant, non-diabetic women in Ethiopia: a cross-sectional study.The Pan African medical journal · 2025Article
- Age and HbA1c in Diabetes: A Negative Association Modified by Red Cell Characteristics.Journal of clinical medicine · 2024Article
- Dementia Prevention Self-Management in Older Thai Adults with Type 2 Diabetes: Development and Psychometric Properties of Two Questionnaires.Nursing reports (Pavia, Italy) · 2024Article
- Trends in clinical characteristics, medication use, and glycemic control in insulin-treated patients with type 1 and type 2 diabetes in Finland in 2012-2019: Nationwide real-world evidence study.Journal of diabetes · 2024Article
- Clinical Risk Assessment and Comparison of Bias between Laboratory Methods for Estimation of HbA1c for Glycated Hemoglobin in Hyperglycemic Patients.Current diabetes reviews · 2024Article
- Assessing the effects of diabetes mellitus on the monocyte-to-lymphocyte ratio and the QuantiFERON-TB gold plus assays for tuberculosis treatment monitoring: a prospective cohort study.Frontiers in immunology · 2024Article
- Diabetic peripheral neuropathy: age-stratified glycemic control.Frontiers in endocrinology · 2024Article
- The effect of age and gender on HbA1c levels in adults without diabetes mellitus.Journal of medical biochemistry · 2023Article
- The prediabetes conundrum: striking the balance between risk and resources.Diabetologia · 2023Article
- Development of a population pharmacokinetic model of pyrazinamide to guide personalized therapy: impacts of geriatric and diabetes mellitus on clearance.Frontiers in pharmacology · 2023Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMeasurement of gylcated hemoglobin A1c (HbA1c) plays a central role in monitoring quality of antidiabetic therapy and in the diagnosis of diabetes. Several studies report increased levels of HbA1c in nondiabetic elderly. However, this observation did not reach incorporation into daily clinical practice or the respective guidelines. The present study aimed to evaluate HbA1c levels in relation to age in two independent population-based cohorts and to derive age-specific reference intervals.
methodsFour thousand two hundred sixty three participants from the Study of Health in Pomerania (SHIP-0) and 4402 participants from the independent study SHIP-Trend were included. HbA1c was determined by means of high-performance liquid chromatography. Multivariable linear regression models were performed. Reference intervals for HbA1c were determined.
resultsReference intervals were derived from a healthy subpopulation with the upper reference limit (URL) for HbA1c of 42.1 mmol/Mol (6.0%) for individuals aged 20-39 years increasing to 43.2 mmol/Mol (6.1%) for individuals aged 40-59 years. For people aged ≥60 years the URL was 47.5 mmol/Mol (6.5%). In both study populations an increase in HbA1c with age was observed. ANOVA revealed up to 8.5 mmol/Mol (0.77%) or 7.3 mmol/Mol (0.68%) higher estimated mean levels of HbA1c in the oldest compared to the youngest age group in SHIP-0 or SHIP-trend, respectively. Linear regression analyses confirmed the positive associations of HbA1c with age which was independent of BMI
conclusionThe present study confirmed the previously observed increase of HbA1c with increasing age in non-diabetic individuals. As a consequence age-dependent reference values for HbA1c were derived from two large and well defined reference populations. Implementation of them into daily practice may improve patient care and diagnosis of diabetes and reduce the risk of misdiagnosis and subsequent overtreatment of diabetes in elderly patients.
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