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  • Combining fasting plasma glucose and glycosylated haemoglobin improved the accuracy for detecting patients with diabetes

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Diagnosis
Combining fasting plasma glucose and glycosylated haemoglobin improved the accuracy for detecting patients with diabetes

https://doi.org/10.1136/ebm.8.6.186

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    (2003) Diabetes Care 26, 290; Anand SS, Razak F, Vuksan V, et al.. Diagnostic strategies to detect glucose intolerance in a multiethnic population.. ;. :. –6.
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 QUESTION: In a multiethnic cohort randomly assembled in Canada, is a combination of fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c) more accurate than FPG alone for diagnosing impaired glucose tolerance (IGT) and diabetes?

    Design

    Optimal diagnostic criteria using FPG, 2 hour post glucose load plasma glucose, and HbA1c to identify patients with IGT and diabetes were determined (using the 1998 WHO diagnostic criteria as the “gold standard”) and compared. Cut points were determined from receiver operating characteristic curves.

    Setting

    3 cities in Canada.

    Participants

    936 Canadians of South Asian, Chinese, and European descent.

    Description of tests and diagnostic standard

    FPG and 2 hour post glucose load (ie, after ingestion of 75 g of oral glucose) plasma glucose were measured using enzymatic methods with a hexokinase reference. HbA1c was analysed using high performance liquid chromatography. The 1998 WHO diagnostic criteria were used as the “gold standard” to classify the participants into …

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    Footnotes

    • Sources of funding: not stated.

    • For correspondence: Dr S S Anand, McMaster University, Hamilton, ON, Canada. anands{at}mcmaster.ca

    • Abstract and commentary also appear in ACP Journal Club.