Comparing incident diabetes as defined by fasting plasma glucose or by HbA_1c. The AusDiab, Inter99 and DESIR studies

Abstract

Diabet. Med. 28, 1311–1318 (2011) Abstract Aim We examined the ability of fasting plasma glucose and HbA1c to predict 5‐year incident diabetes for an Australian cohort and a Danish cohort and 6‐year incident diabetes for a French cohort, as defined by the corresponding criteria. Methods We studied 6025 men and women from AusDiab (Australian), 4703 from Inter99 (Danish) and 3784 from DESIR (French), not treated for diabetes and with fasting plasma glucose < 7.0 mmol/l and HbA1c < 48 mmol/mol (6.5%) at inclusion. Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/l and/or treatment for diabetes or as HbA1c ≥ 48 mmol/mol (6.5%) and/or treatment for diabetes. Results For AusDiab, incident fasting plasma glucose‐defined diabetes was more frequent than HbA1c‐defined diabetes (PMcNemar < 0.0001), the reverse applied to Inter99 (PMcNemar < 0.007) and for DESIR there was no difference (PMcNema = 0.17). Less than one third of the incident cases were detected by both criteria. Logistic regression models showed that baseline fasting plasma glucose and baseline HbA1c predicted incident diabetes defined by the corresponding criteria. The standardized odds ratios (95% confidence interval) for HbA1c were a little higher than for fasting plasma glucose, but not significantly so. They were respectively, 5.0 (4.1–6.1) and 4.1 (3.5–4.9) for AusDiab, 5.0 (3.6–6.8) and 4.8 (3.6–6.3) for Inter99, 4.8 (3.6–6.5) and 4.6 (3.6–5.9) for DESIR. Conclusions Fasting plasma glucose and HbA1c are good predictors of incident diabetes defined by the corresponding criteria. Despite Diabetes Control and Complications Trial‐alignment of the three HbA1c assays, there was a large difference in the HbA1c distributions between these studies, conducted some 10 years ago. Thus, it is difficult to compare absolute values of diabetes prevalence and incidence based on HbA1c measurements from that time.

HbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis

“…Mean HbA 1c differed among studies, more than that of glucose, as we have shown in other analyses [28, 29]. Indeed, in the Japanese-Americans study [24], HbA 1c had a much higher mean than in other studies.…”

HbA1c, fasting plasma glucose and the prediction of diabetes: Inter99, AusDiab and D.E.S.I.R.

“…In strictly non-diabetic subjects, those with HbA1c < 6.5% and by HbA1c ≥ 6.5% and/or treatment, with an area under the receiver operating characteristic curve of 0.84, 0.91 and 0.82 for Inter99, AusDiab and D.E.S.I.R. respectively, indicating that HbA1c was able to discriminate incident diabetes as defined by HbA1c [28].…”

“…We have previously studied incident diabetes, where diabetes was defined by treatment and/or HbA1c ≥ 6.5% [28]. In strictly non-diabetic subjects, those with HbA1c < 6.5% and by HbA1c ≥ 6.5% and/or treatment, with an area under the receiver operating characteristic curve of 0.84, 0.91 and 0.82 for Inter99, AusDiab and D.E.S.I.R.…”

Evaluation of Glycated Hemoglobin (HbA1c) for Diagnosing Type 2 Diabetes and Prediabetes among Palestinian Arab Population

“…The Australians recommended the use of two cut-off values; ≤ 5.5% to ‘rule-out’ and ≥ 7.0% to ‘rule-in’ diabetes [17]. Variations in prevalence of diabetes [18]–[22] and prediabetes [23] due to ethnicity have been documented.…”