A1C for screening and diagnosis of type 2 diabetes in routine clinical practice

Zhong Xian Lu, Karen Walker, Kerin O'Dea, Ken Sikaris, Jonathan Shaw

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Abstract

OBJECTIVE: To evaluate A1C for screening and diagnosis of undiagnosed type 2 diabetes defined by oral glucose tolerance testing in clinical and general populations. RESEARCH DESIGN AND METHODS: A1C cut offs (<or =5.5 to rule out diabetes; > or =7.0 to rule in diabetes) were derived from a clinical group (Melbourne Pathology [MP] group: n = 2,494; undiagnosed diabetes 34.6 ) and then evaluated in a population-based sample (AusDiab group: n = 6,015; undiagnosed diabetes 4.6 ). RESULTS: For diabetes in the MP and AusDiab groups, A1C at 5.5 gave sensitivities of 98.7 and 83.5 , while A1C at 7.0 gave specificities of 98.2 and 100 , respectively. Many (61.9-69.3 ) with impaired A1C (5.6-6.9 ) in both populations had abnormal glucose status. CONCLUSIONS: A1C <or =5.5 and > or =7.0 predicts absence or presence of type 2 diabetes, respectively, while at A1C 6.5-6.9 diabetes is highly probable in clinical and population settings. A high proportion of people with impaired A1C have abnormal glucose status requiring follow-up.
Original languageEnglish
Pages (from-to)817 - 819
Number of pages3
JournalDiabetes Care
Volume33
Issue number4
DOIs
Publication statusPublished - 2010

Cite this

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title = "A1C for screening and diagnosis of type 2 diabetes in routine clinical practice",
abstract = "OBJECTIVE: To evaluate A1C for screening and diagnosis of undiagnosed type 2 diabetes defined by oral glucose tolerance testing in clinical and general populations. RESEARCH DESIGN AND METHODS: A1C cut offs ( or =7.0 to rule in diabetes) were derived from a clinical group (Melbourne Pathology [MP] group: n = 2,494; undiagnosed diabetes 34.6 ) and then evaluated in a population-based sample (AusDiab group: n = 6,015; undiagnosed diabetes 4.6 ). RESULTS: For diabetes in the MP and AusDiab groups, A1C at 5.5 gave sensitivities of 98.7 and 83.5 , while A1C at 7.0 gave specificities of 98.2 and 100 , respectively. Many (61.9-69.3 ) with impaired A1C (5.6-6.9 ) in both populations had abnormal glucose status. CONCLUSIONS: A1C or =7.0 predicts absence or presence of type 2 diabetes, respectively, while at A1C 6.5-6.9 diabetes is highly probable in clinical and population settings. A high proportion of people with impaired A1C have abnormal glucose status requiring follow-up.",
author = "Lu, {Zhong Xian} and Karen Walker and Kerin O'Dea and Ken Sikaris and Jonathan Shaw",
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A1C for screening and diagnosis of type 2 diabetes in routine clinical practice. / Lu, Zhong Xian; Walker, Karen; O'Dea, Kerin; Sikaris, Ken; Shaw, Jonathan.

In: Diabetes Care, Vol. 33, No. 4, 2010, p. 817 - 819.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A1C for screening and diagnosis of type 2 diabetes in routine clinical practice

AU - Lu, Zhong Xian

AU - Walker, Karen

AU - O'Dea, Kerin

AU - Sikaris, Ken

AU - Shaw, Jonathan

PY - 2010

Y1 - 2010

N2 - OBJECTIVE: To evaluate A1C for screening and diagnosis of undiagnosed type 2 diabetes defined by oral glucose tolerance testing in clinical and general populations. RESEARCH DESIGN AND METHODS: A1C cut offs ( or =7.0 to rule in diabetes) were derived from a clinical group (Melbourne Pathology [MP] group: n = 2,494; undiagnosed diabetes 34.6 ) and then evaluated in a population-based sample (AusDiab group: n = 6,015; undiagnosed diabetes 4.6 ). RESULTS: For diabetes in the MP and AusDiab groups, A1C at 5.5 gave sensitivities of 98.7 and 83.5 , while A1C at 7.0 gave specificities of 98.2 and 100 , respectively. Many (61.9-69.3 ) with impaired A1C (5.6-6.9 ) in both populations had abnormal glucose status. CONCLUSIONS: A1C or =7.0 predicts absence or presence of type 2 diabetes, respectively, while at A1C 6.5-6.9 diabetes is highly probable in clinical and population settings. A high proportion of people with impaired A1C have abnormal glucose status requiring follow-up.

AB - OBJECTIVE: To evaluate A1C for screening and diagnosis of undiagnosed type 2 diabetes defined by oral glucose tolerance testing in clinical and general populations. RESEARCH DESIGN AND METHODS: A1C cut offs ( or =7.0 to rule in diabetes) were derived from a clinical group (Melbourne Pathology [MP] group: n = 2,494; undiagnosed diabetes 34.6 ) and then evaluated in a population-based sample (AusDiab group: n = 6,015; undiagnosed diabetes 4.6 ). RESULTS: For diabetes in the MP and AusDiab groups, A1C at 5.5 gave sensitivities of 98.7 and 83.5 , while A1C at 7.0 gave specificities of 98.2 and 100 , respectively. Many (61.9-69.3 ) with impaired A1C (5.6-6.9 ) in both populations had abnormal glucose status. CONCLUSIONS: A1C or =7.0 predicts absence or presence of type 2 diabetes, respectively, while at A1C 6.5-6.9 diabetes is highly probable in clinical and population settings. A high proportion of people with impaired A1C have abnormal glucose status requiring follow-up.

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JO - Diabetes Care

JF - Diabetes Care

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