Diagnosing diabetes: a new paradigm

Lee, R; Chowdhury, Tahseen A

doi:10.1093/qjmed/hcs082

Cited by 2 publications

(4 citation statements)

References 11 publications

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“…There are currently many methods to assess abdominal obesity, and there are also multiple methods to index glucose metabolism and diagnose diabetes, including the oral glucose tolerance test (OGTT), fasting blood glucose, hemoglobin A1c (HbA1c), and homeostasis model assessment (HOMA-IR) [13]. Overall, the OGTT is the gold standard, and research has consistently demonstrated the OGTT's unique ability to diagnose glucose-intolerant and diabetic cases that are missed when using other strategies [4, 14].…”

Section: Introductionmentioning

confidence: 99%

Sagittal Abdominal Diameter, Waist Circumference, and BMI as Predictors of Multiple Measures of Glucose Metabolism: An NHANES Investigation of US Adults

Firouzi

Tucker

LeCheminant

et al. 2018

Journal of Diabetes Research

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The objective was to compare associations between sagittal abdominal diameter (SAD), waist circumference, and BMI to the oral glucose tolerance test (OGTT), along with fasting glucose, HbA1c, and HOMA-IR, in a nationally representative sample of 3582 US adults. The study also analyzed the effect of multiple covariates on the anthropometric and glucose metabolism associations. A cross-sectional design was used. SAD was assessed using an abdominal caliper. All other data were collected following strict NHANES protocols. The OGTT was the primary variable used to index glucose metabolism. Fasting glucose, HbA1c, and HOMA-IR were also evaluated. Results showed that mean ± SE values were as follows: SAD: 22.3 ± 0.1 cm, waist circumference: 98.0 ± 0.4 cm, BMI: 28.6 ± 0.2 kg/m2, OGTT: 113.9 ± 1.0 mg/dL, fasting glucose: 99.6 ± 0.3 mg/dL, HbA1c: 5.4 ± 0.01%, and HOMA-IR: 3.2 ± 0.1. Compared to waist circumference and BMI, SAD consistently emerged as the best predictor of glucose metabolism, before and after adjusting for the covariates, and with the sample stratified by gender, race, or age. SAD was not a better predictor of OGTT among normal-weight adults or non-Hispanic Black adults. Due to the ease of taking SAD measurements, we recommend that healthcare providers use this simple method to more precisely predict diabetes risk, especially among overweight and obese adults.

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Section: Introductionmentioning

confidence: 99%

Sagittal Abdominal Diameter, Waist Circumference, and BMI as Predictors of Multiple Measures of Glucose Metabolism: An NHANES Investigation of US Adults

Firouzi

Tucker

LeCheminant

et al. 2018

Journal of Diabetes Research

View full text Add to dashboard Cite

show abstract

“…The patients included in this study were unknown to the DCs; therefore, they were not referred to specialised clinics for the initial assessment and are not included in any structured diagnostic and therapeutic pathway. Possibly, they could be diagnosed as T2DM and cared exclusively for by their GP through diet and lifestyle advice, or they could be undiagnosed or they could have one abnormal HbA1c value due to being affected by pre-diabetes or by one of other conditions artificially increasing HbA1c values, carbamylated haemoglobin (renal failure), hypertriglyceridaemia, hyperbilirubinaemia, or iron deficiency [6] , [11] .…”

Section: Methodsmentioning

confidence: 99%

“…In 2011, a high level of glycated haemoglobin (HbA1c) was endorsed by the World Health Organisation (WHO) as a sufficient criterion for T2DM using a diagnosis threshold of ≥ 6.5% (48 mmol/mol) [5] . The WHO states that diagnosis can be based on either glucose tests or HbA1c, although in asymptomatic patients, elevated HbA1c or fasting glucose should be confirmed by repeating the same test [6] .…”

Section: Introductionmentioning

confidence: 99%