Validation of an algorithm combining haemoglobin A1c and fasting plasma glucose for diagnosis of diabetes mellitus in UK and Australian populations

Manley, S E; Sikaris, Ken; Lu, Zhong X.; Nightingale, Peter; Stratton, I M; Round, Rachel A.; Baskar, Varadarajan; Gough, Stephen; Smith, Janet

doi:10.1111/j.1464-5491.2008.02652.x

Cited by 37 publications

(48 citation statements)

References 25 publications

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“…It is clear that fluorescence intensity of DM group increased significantly compared with normal group (p<0.05) while that of intervention group decreased and no statistic difference of fluorescence intensity between normal group and diet intervention group was observed. Similar phenomenon was found in the differences of concentration of GHbA1c, glycated protein which is used as a golden standard in the diagnosis and monitoring of diabetes mellitus [29]. These results showed that the inhibition of TP on glycation occured in diabetic mice.…”

Section: Journal Of Food and Nutrition Researchsupporting

confidence: 69%

Influence of Tea Polyphenols on the Formation of Advanced Glycation End Products (AGEs) in vitro and in vivio

Peng¹,

Zhang²

2014

JFNR

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The effects of tea polyphenols (TP) on the formation of advanced glycation end products (AGEs) were investigated using glutamicacid -glucose and BSA -glucose model systems at 90°C and 37°C, respectively. The spectral characteristics of glycation products were measured. Additionally, a type 1 diabetesmellitus (DM) animal model of Kunming mice by injecting streptozocin (STZ) was used to study the formation of AGEs in vivo. Tea polyphenols (TP) were given to mice at a dose of 200mg/kg bodyweight continuously for 8 weeks. Mice were then sacrificed and the glycosylated hemoglobin (GHbA1c) and fluorescence of AGEs in serum were measured to illustrate the effects of TP on protein glycation in vivo. The in vitro experiment results showed that the production of AGEs was decreased by TP in a dose-dependent manner TP addition reduced the accumulation of GHbA1c and AGEs in DM mice and relieved the symptoms of diabetic nephropathy (DN), which is an important indicator of diabetic complications caused by AGEs. Thus, TP might be used as an important ingredient in dietary approaches for intervention of diabetes and improved health.

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Section: Journal Of Food and Nutrition Researchsupporting

confidence: 69%

Influence of Tea Polyphenols on the Formation of Advanced Glycation End Products (AGEs) in vitro and in vivio

Peng¹,

Zhang²

2014

JFNR

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“…Established risk scores and tools were calculated within the Mesy-Bepo cohort according to the information provided in the respective publications (7,17,18).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, a regression-analysis-based questionnaire may have a better screening quality, if specifically individuals with IGM are targeted. A recent publication also proposed a decision tree to identify subjects with existing T2DM (7). We also applied this tree to our cohort.…”

Section: Discussionmentioning

confidence: 99%

Decision trees as a simple-to-use and reliable tool to identify individuals with impaired glucose metabolism or type 2 diabetes mellitus

Hische

Luis-Dominguez²,

Pfeiffer³

et al. 2010

European Journal of Endocrinology

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Objective: The prevalence of unknown impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or type 2 diabetes mellitus (T2DM) is high. Numerous studies demonstrated that IFG, IGT, or T2DM are associated with increased cardiovascular risk, therefore an improved identification strategy would be desirable. The objective of this study was to create a simple and reliable tool to identify individuals with impaired glucose metabolism (IGM). Design and methods: A cohort of 1737 individuals (1055 controls, 682 with previously unknown IGM) was screened by 75 g oral glucose tolerance test (OGTT). Supervised machine learning was used to automatically generate decision trees to identify individuals with IGM. To evaluate the accuracy of identification, a tenfold cross-validation was performed. Resulting trees were subsequently re-evaluated in a second, independent cohort of 1998 individuals (1253 controls, 745 unknown IGM). Results: A clinical decision tree included age and systolic blood pressure (sensitivity 89.3%, specificity 37.4%, and positive predictive value (PPV) 48.0%), while a tree based on clinical and laboratory data included fasting glucose and systolic blood pressure (sensitivity 89.7%, specificity 54.6%, and PPV 56.2%). The inclusion of additional parameters did not improve test quality. The external validation approach confirmed the presented decision trees. Conclusion: We proposed a simple tool to identify individuals with existing IGM. From a practical perspective, fasting blood glucose and blood pressure measurements should be regularly measured in all individuals presenting in outpatient clinics. An OGTT appears to be useful only if the subjects are older than 48 years or show abnormalities in fasting glucose or blood pressure.

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“…Anecdotally, HbA1c has been used in community opportunistic screening for many years, however without the support of guidelines, therefore there was no standardisation of which HbA1c cut-point which detect T2DM and this was left to the discretion of the health care professional (Ealovega et al, 2004). There is accumulating evidence that HbA1c has equally as good if not higher discriminatory ability for detecting T2DM and cardiovascular disease (CVD) than FPG (Perry et al, 2001;Kim et al, 2008;Droumaguet et al, 2006;Manley et al, 2009;Buell et al 2007;Rohlfing et al, 2000;Selvin et al, 2010).…”

Section: Glycated Haemoglobin (Hba1c)mentioning

confidence: 99%

Can vitamin D replacement reduce insulin resistance in South Asians with vitamin D deficiency?

Davies¹

2012

http://isrctn.org/>

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BackgroundThe incidence of Type 2 Diabetes Mellitus (T2DM) is increasing rapidly, therefore there is a need to detect this disease earlier and more efficiently, and also to identify novel risk factors that may aid both its detection and prevention.Aims: 1) To discuss the benefits and disadvantages of using HbA1c for diagnosis of T2DM and impaired glucose regulation (IGR).2) To explore the impact on prevalence of using HbA1c to detect T2DM and IGR in global and local populations.3) To determine if diagnostic cut-points are equivalent in different ethnic groups 4) To determine the use of the triglyceride-to-HDL ratio and its association with insulin resistance and whether statins and liver enzymes predict T2DM. 5) To investigate if Vitamin D deficiency has a role in the prevention of T2DM by designing a 6 month randomised controlled trial on vitamin D replacement.Key findings: 1) Using HbA1c for diagnosis has some logistical advantages over glucose testing, but may not detect the same people as having T2DM or IGR.2) In Leicestershire, using HbA1c will increase numbers of people with T2DM and IGR. On global level, there will be regional variation on the effect on prevalence.3) HbA1c, fasting and two hour plasma glucose are independently higher in South Asians (SA). Complications of T2DM may begin earlier in SA.4) The triglyceride-to-HDL ratio associates with insulin resistance in Europeans and SA men but not women. Statin therapy reduces the risk of incident T2DM.Liver enzymes predict T2DM in Europeans but not SA.

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Validation of an algorithm combining haemoglobin A_1c and fasting plasma glucose for diagnosis of diabetes mellitus in UK and Australian populations

Abstract: Use of this algorithm would simplify procedures for diagnosis of diabetes and could also be used for monitoring pre-diabetes. Validation is now required in other populations and patient groups.

Cited by 37 publications

References 25 publications

Influence of Tea Polyphenols on the Formation of Advanced Glycation End Products (AGEs) <i>in vitro</i> and <i>in vivio</i>

Influence of Tea Polyphenols on the Formation of Advanced Glycation End Products (AGEs) <i>in vitro</i> and <i>in vivio</i>

Decision trees as a simple-to-use and reliable tool to identify individuals with impaired glucose metabolism or type 2 diabetes mellitus

Can vitamin D replacement reduce insulin resistance in South Asians with vitamin D deficiency?

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