ArticleDiabetes research and clinical practice2022
Potential misclassification of diabetes and prediabetes in the U.S.: Mismatched HbA1c and glucose in NHANES 2005-2016.
Article in Diabetes research and clinical practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 17 citations in OpenAlex.
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- Sex-specific in the nonlinear associations of hemoglobin glycation index and all-cause mortality in the general US adult population: results from NHANES 1999-2018.Nutrition & metabolism · 2026Article
- Association between hemoglobin glycation index and cognitive function: Evidence in the elderly.PloS one · 2026Article
- An inflammatory biomarker panel for prediabetes classification using interpretable machine learning.PloS one · 2026Article
- Diagnosis of diabetes without oral glucose tolerance test is associated with increased mortality in older adults.Scientific reports · 2025Article
- Assessing Patterns of Continuous Glucose Monitoring Use and Metrics of Glycemic Control in Type 1 Diabetes and Type 2 Diabetes Patients in the Veterans Health Care System: Integrating Continuous Glucose Monitoring Device Data with Electronic Health Records Data.Diabetes technology & therapeutics · 2024Observational
- Association between the triglyceride glucose index and obstructive sleep apnea and its symptoms: results from the NHANES.Lipids in health and disease · 2024Article
- Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes.Endocrinology, diabetes & metabolism · 2023Article
- Early postpartum HbA1c after hyperglycemia first detected in pregnancy-Imperfect but not without value.PloS one · 2023Article
- Diabetes update: What's new, what's interesting.Journal of diabetes · 2022Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
aimsTo assess the prevalence and clinical implications of "mismatches" between HbA1c and glucose levels in the United States across the life course.
methodsParticipants ages 12-79 years from U.S. National Health and Nutrition Examination Survey (NHANES) 2005-2016 without known diagnosis of diabetes and who had a 75 g oral glucose tolerance test were included. Previously undiagnosed diabetes (DM), prediabetes, and normal glucose metabolism (NGM) were defined using American Diabetes Association cut-points. Mismatches were defined by the hemoglobin glycation index (HGI).
resultsIn 10,361 participants, 5% and 41% had diabetes and prediabetes, respectively, by fasting or 2-hour glucose criteria. By HbA1c criteria, the high HGI tertile consisted of mostly abnormal classification (3% DM, 52% prediabetes) and the low HGI tertile contained mostly normal classification (78% NGM). Across all ages, 15% (weighted: 30 million individuals) had clinically significant mismatches of HGI magnitude ≥+0.5% (i.e., high mismatch) or ≤-0.5% (low mismatch). Mismatch was most common in older adults and non-Hispanic Black participants.
conclusionsMismatches of clinically significant magnitude could lead to HbA1c-related misdiagnosis or inappropriate management in up to 30 million Americans. Older adults, non-Hispanic Black individuals, and others with high mismatches may benefit from complementing HbA1c with additional diagnostic and management strategies.
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