Discordance between Fasting Plasma Glucose (FPG) and HbA1c in Diagnosing Diabetes and Pre-diabetes in The Malaysian Cohort

Abstract

Objective. In this present study, we aim to evaluate the accuracy of the HbA1c relative to fasting plasma glucose (FPG) in the diagnosis of diabetes and pre-diabetes among The Malaysian Cohort (TMC) participants.Methodology. FPG and HbA1c were taken from 40,667 eligible TMC participants that have no previous history of diabetes, aged between 35-70 years and were recruited from 2006 -2012. Participants were classified as normal, diabetes and pre-diabetes based on the 2006 World Health Organization (WHO) criteria. Statistical analyses were performed using ANOVA and Chi-square test, while Pearson correlation and Cohen's kappa were used to examine the concordance rate between FPG and HbA1c.Results. The study samples consisted of 16,224 men and 24,443 women. The prevalence of diabetes among the participants was 5.7% and 7.5% according to the FPG and HbA1c level, respectively. Based on FPG, 10.6% of the participants had pre-diabetes but this increased to 14.2% based on HbA1c (r=0.86; P<0.001).

Causal Relationships Between Glycemic Traits and Myopia

“… 34 Previous studies have shown a significant discordance in the diagnosis of diabetes between HbA1c and fasting blood glucose. 35 , 36 Second, valid genetic instruments for HbA1c levels ( n = 213) are as much as 10 times higher than fasting glucose levels ( n = 22). These findings suggest that, in clinical practice, a strict glycemic control strategy that encompasses regular exercise and a healthy diet is necessary to reduce the risk of myopia.…”

Stability of glycated haemoglobin (HbA1c) measurements from whole blood samples kept at −196°C for seven to eight years in The Malaysian Cohort study

“…In addition, all instruments used in this study were certified by the National Glycohemoglobin Standardization Program (NGSP) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) in 2020 and 2021, as well as standardized to the method used by the Diabetes Control and Complications Trial (DCCT). All assays were performed according to the manufacturer's instructions in an accredited bioanalytical laboratory 7 …”

“…As for the original protocol for samples in 2012 and 2013, fresh whole blood samples from EDTA tubes were measured for HbA1c using Premier Hb9210 HbA1c analyzer (Trinity Biotech, WW, Ireland) that utilizes boronate affinity technology for high-performance liquid chromatography (HPLC). 7 The quoted machine's reportable values range between 4% and 18% HbA1c. 19 For this current study (in 2020 and 2021), we retrieved the whole blood samples from the same participants we measured in 2012 and 2013 stored at −196°C in a liquid nitrogen tank at TMC's biobank.…”

“…All assays were performed according to the manufacturer's instructions in an accredited bioanalytical laboratory. 7 Some studies used both boronate affinity and cation exchange HPLC systems as the reference when assessing HbA1c concentration. 22,23 The UK Biobank has used and certified the Variant™ II Turbo analyzer as the reference method for HbA1c measurement.…”

The triglyceride glucose-waist-to-height ratio outperforms obesity and other triglyceride-related parameters in detecting prediabetes in normal-weight Qatari adults: A cross-sectional study

“…To date, the gold standard test for prediabetes diagnosis is the oral glucose tolerance test (OGTT), fasting plasma glucose (FPG), and HbA 1c levels (11,12). However, several studies have shown discordance between HbA 1c and glycemia (17)(18)(19)(20)(21). This discordance could have a significant impact on clinical practice.…”