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HbA1c Alone Underestimates Diabetes Risk
Researchers find what’s done in practice is best
Using just HbA1c measures in health surveys could leave individuals undiagnosed even through they would benefit from interventions for diabetes. In fact, population health experts should follow what is commonly done in practice, a recent analysis showed.
Different biomarkers and definitions can lead to revised estimates of diabetes prevalence, researchers concluded after reviewing data from 96 population-based health examination surveys. At least two of the following biomarkers were used in the surveys: HbA1c, fasting plasma glucose (FPG), or FPG-or-oral glucose tolerance test (OGTT).
Investigators found the lowest prevalence when diabetes was defined based on HbA1c alone, and highest in assessments based on FPG-or-OGTT. They noted, for example, that an FPG-alone-based prevalence of 10% would be revised to about 13% based on FPG-or-OGTT.
The good news is that at the practice level, OGTT is often seen as the most reliable test, and appears to be used most.
Citation: NCD Risk Factor Collaboration. Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participants. Lancet Diabetes Endocrinol. 2015; 3: 624-637.