Review: glycated haemoglobin A1c and fasting plasma glucose screening tests have similar sensitivities and specificities for early detection of type 2 diabetes

doi:10.1136/ebm.12.5.152

Evidence-Based Medicine 2007;12:152; doi:10.1136/ebm.12.5.152

Diagnosis

Review: glycated haemoglobin A_1c and fasting plasma glucose screening tests have similar sensitivities and specificities for early detection of type 2 diabetes

Bennett CM, Guo M, Dharmage SC. HbA1c as a screening tool for detection of type 2 diabetes: a systematic review. Diabet Med 2007;24:333–43.[CrossRef][Medline]

Q How do the glycated haemoglobin A_1c (HbA_1c) and fasting plasma glucose (FPG) tests compare as screening tools for early detection of type 2 diabetes?

Clinical impact ratings GP/FP/Primary care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ IM/Ambulatory care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Endocrine $*$ $*$ $*$ $*$ $*$ ${star}$ ${star}$

Key Words: diabetes mellitus (type 2) • haemoglobin A (glycosylated) • blood glucose • glucose intolerance

The first 150 words of the full text of this article appear below.

METHODS

Data sources: Medline, EMBASE/Excerpta Medica (1994 to September 2004), andbibliographies of relevant articles.

Study selection and assessment: English language cross-sectional studies that compared the HbA_1Ctest with the FPG test as screening tools for detecting type2 diabetes, reported sensitivities and specificities using the75 g oral glucose tolerance test (OGTT) as the reference standard,and reported HbA_1c test results in a format compatible withthat of the Diabetes Control and Complications Trial. 9 studies(n = 19 500, 13–92 y) published in 1998–2004 metthe selection criteria; 4 studies were community-based, and5 were hospital-based. Quality assessment of individual studieswas based on the sampling frame and size, measurements of HbA_1cand FPG, adequacy of test descriptions, and 80% verificationwith OGTT.

Outcomes: sensitivity, specificity, and likelihood ratios (LRs).

MAIN RESULTS

In $>=$ 2 studies, receiver operating characteristic curves identified5.9%, 6.1%, and 6.2% as optimal HbA_1c cut-points and 5.6 mmol/l. . . [Full text of this article]

Chris L Bryson, MD, MS, Edward J Boyko, MD, MPH

Veterans Affairs Puget Sound Health Care System,
Seattle, Washington, USA

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