HbA1c of 6.5% to Diagnose Diabetes Mellitus — Does It Work for Us — The Bellville South Africa StudyReport as inadecuate




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Background

HbA1c has been the gold standard for glycaemic control follow-up for decades. In 2009, a level of 6.5% 48 mmol-mol was proposed as diagnostic for diabetes. We test this cut-off in our community.

Methods

Participants 946 from a community-based study were screened for diabetes using either a fasting blood glucose or oral glucose tolerance test OFTT. The HbA1c cut-off of 6.5% was tested for each group. A receiver operator characteristic ROC curve for both groups was generated to establish an optimal cut-off.

Results

Our study included 224 23.7% males and 722 76.3% females. Using fasting blood glucose alone, 117 14% were diagnosed with diabetes −50% had an HbA1c value of ≥6.5% 48 mmol-mol. Using an OGTT, 147 18% were diagnosed with diabetes −46% had an HbA1c value of ≥6.5% 48 mmol-mol. ROC curves found a level of 6.1% 43 mmol-mol to be optimal in both groups AUC 0.85 and 0.82 respectively. The sensitivities were 80% and 75% and the specificities 77% and 78% respectively.

Conclusions

A cut off of 6.5% 48 mmol-mol is a good diagnostic tool with its high specificity; however the low sensitivity limits its use. We found a level of 6.1% 43 mmol-mol to be optimal. This emphasizes the need for evidenced based values to be established in various population groups.



Author: Annalise E. Zemlin, Tandi E. Matsha , Mogamat S. Hassan, Rajiv T. Erasmus

Source: http://plos.srce.hr/



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