期刊
ANNALS OF MEDICINE
卷 44, 期 2, 页码 170-177出版社
TAYLOR & FRANCIS LTD
DOI: 10.3109/07853890.2010.531759
关键词
Glycosylated hemoglobin A; impaired fasting glucose; impaired glucose tolerance; normal glucose tolerance; oral glucose tolerance test; type 2 diabetes mellitus
资金
- German Research Foundation (DFG) [RA 459/2-1]
- German Federal Ministry of Health
- Ministry of Innovation, Science, Research and Technology of the State of North-Rhine-Westfalia
- Helmholtz Zentrum Munchen
- German Research Center for Environmental Health
- German Federal Ministry of Education, Science, Research and Technology
- State of Bavaria
Objective. The American Diabetes Association (ADA) has recently recommended HbA1c for diagnosing diabetes as an alternative to glucose-based criteria. We compared the new HbA1c-based criteria for diagnosis of diabetes and prediabetes with the glucose-based criteria. Research design and methods. In the population-based German KORA surveys (S4/F4) 1,764 non-diabetic participants aged 31-60 years and 896 participants aged 61-75 years underwent measurements of HbA1c, fasting plasma glucose (FPG), and 2-h glucose. Results. Only 20% of all subjects diagnosed with diabetes by glucose or HbA1c criteria had diabetes by both criteria; for prediabetes, the corresponding figure was 23%. Using HbA1c >= 6.5%, the prevalence of diabetes was strongly reduced compared to the glucose criteria (0.7% instead of 2.3% in the middle-aged, 2.9% instead of 7.9% in the older subjects). Only 32.0% (middle-aged) and 43.2% (older group) of isolated impaired glucose tolerance (i-IGT) cases were detected by the HbA1c criterion (5.7% <= HbA1c < 6.5%). Conclusion. By glucose and the new HbA1c diabetes criteria, different subjects are diagnosed with type 2 diabetes in middle-aged as well as older subjects. The new HbA1c criterion lacks sensitivity for impaired glucose tolerance.
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