Performance of A1C Versus OGTT for the Diagnosis of Prediabetes in a Community-Based Screening

Authors

Jenny E. Camacho, Department of Pediatrics, University of New Mexico, MSC 10 5590, 1 University of New Mexico, Albuquerque, NM 87131
Vallabh O. Shah, Department of Molecular Biology and Biochemistry, University of New Mexico, MSC MSC08 4670, 1 University of New Mexico, Albuquerque, NM 87131
Ronald Schrader, Department of Internal Medicine/Endocrinology- 5 ACC; MSC 10 5590, 1 University of New Mexico, Albuquerque, NM 87131
Craig S. Wong, Department of Pediatrics, University of New Mexico, MSC 10 5590, 1 University of New Mexico, Albuquerque, NM 87131
Mark R. Burge, Department of Internal Medicine/Endocrinology- 5 ACC; MSC 10 5590, 1 University of New Mexico, Albuquerque, NM 87131

Document Type

Article

Publication Date

11-1-2016

Abstract

OBJECTIVE: Reliable identification of individuals at risk for developing diabetes is critical to instituting preventative strategies. Studies suggest that the accuracy of using hemoglobin A1c as a sole diagnostic criterion for diabetes may be variable across different ethnic groups. We postulate that there will be lack of concordance between A1c and the oral glucose tolerance test (OGTT) for diagnosing prediabetes across Hispanic and non-Hispanic white (NHW) populations.

METHODS: A total of 218 asymptomatic adults at risk for type 2 diabetes (T2D) were assessed with A1c and OGTT for the diagnosis of prediabetes. Glucose homeostasis status was assigned as no diabetes (A1c6.4% [46 mmol/mol]). Inclusion criteria were age >18 years and at least one of the following: a family history of diabetes, a history of gestational diabetes, Hispanic ethnicity, non-Caucasian race, or obesity. Subjects received a fasting 75-g OGTT and A1c on the same day. Bowker's test of symmetry was employed to determine agreement between the tests.

RESULTS: Data from 99 Hispanic patients and 79 NHW patients were analyzed. There was no concordance between A1c and OGTT for Hispanic (P = .002) or NHW individuals (P = .003) with prediabetes.

CONCLUSION: A1c is discordant with OGTT among Hispanic and NHW subjects for the diagnosis of prediabetes. Sole use of A1c to designate glycemic status will result in a greater prevalence of prediabetes among Hispanic and NHW New Mexicans.

ABBREVIATIONS: A1c = hemoglobin A1c BMI = body mass index CDC = Centers for Disease Control CI = confidence interval FPG = fasting plasma glucose NHW = non-Hispanic white OGTT = oral glucose tolerance test T2D = type 2 diabetes WHO = World Health Organization.

Publisher

American Association of Clinical Endocrinologists

Publication Title

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

ISSN

1530-891X

Volume

22

Issue

11

First Page

1288

Last Page

1295

Recommended Citation

Camacho JE, Shah VO, Schrader R, Wong CS, Burge MR. PERFORMANCE OF A1C VERSUS OGTT FOR THE DIAGNOSIS OF PREDIABETES IN A COMMUNITY-BASED SCREENING. Endocr Pract. 2016 Nov;22(11):1288-1295. doi: 10.4158/EP161267.OR. Epub 2016 Aug 2. PMID: 27482613; PMCID: PMC5278882.