ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2024
Is the Current Cut Point for Glycated Haemoglobin (HbA1c) Correct for Diagnosing Diabetes Mellitus in Premenopausal Women? Evidence to Inform Discussion.
Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sex-specific differences in the prevalence of intermediate hyperglycaemia states: A systematic review and meta-analysis.Diabetic medicine : a journal of the British Diabetic Association · 2026Pooled it
- [Sex and gender-specific aspects in prediabetes and diabetes mellitus - Clinical recommendations (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Validity of hemoglobin A1C for screening prediabetes and diabetes in the Iranian population: analysis of National surveillance data.Scientific reports · 2026Article
- Cardiovascular contributions to dementia: Examining sex differences and female-specific factors.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
- Consistency of the personalized glycated haemoglobin (pHbA1c) methodology over time in people with type 1 diabetes (T1D) using continuous glucose monitoring.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- 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
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWomen are on average diagnosed with diabetes mellitus at later age than men but have higher mortality. As the diagnosis of diabetes mellitus is primarily based on HbA1c, the use of a non-specific reference range and cut point for diabetes mellitus that does not account for gender differences in diabetes could potentially lead to underdiagnosis of diabetes mellitus in women and missed opportunities for intervention. We investigated whether a contributing factor to the later diagnosis in women may be a difference in distribution of HbA1c in premenopausal women versus men of the same age by comparing HbA1c values in men and women across multiple sites in the UK.
methodsWe analysed the HbA1c levels of 146,907 individuals who underwent single testing only and had HbA1c ≤ 50 mmol/mol between 2012 and 2019 in one laboratory (cohort 1). This was replicated in six laboratories with 938,678 individuals tested between 2019 and 2021 (cohort 2).
resultsIn cohort 1, women < 50 years old had an HbA1c distribution markedly lower than that in men by a mean of 1.6 mmol/mol (p < 0.0001), while the difference in the distribution of HbA1c for individuals aged ≥ 50 years was less pronounced (mean difference 0.9 mmol/mol, p < 0.0001). For individuals under the age of 50, HbA1c in women lagged by up to 10 years compared to men. Similar findings were found in cohort 2. We estimated an additional 17% (n = 34,953) of undiagnosed women aged < 50 years in England and Wales could be reclassified to have diabetes mellitus, which may contribute to up to 64% of the difference in mortality rates between men/women with diabetes mellitus aged 16-50 years.
conclusionThe HbA1c cut point for diagnosis of diabetes mellitus may need to be re-evaluated in women under the age of 50 years. Early identification of diabetes mellitus in women has the potential to improve women's health outcomes in the longer term.
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