Use of HbA1c in the diagnosis of diabetes and prediabetes: Sensitivity versus specificity

摘要

The increasing prevalence of diabetes mellitus (DM) globally, particularly in developing countries, will have substantial ramifications in terms of increased micro- and macrovascular complications and the attendant huge economic burden. Type 2 diabetes mellitus (T2DM) is a chronic disease that has a long latent phase of glycemic dysregula-tion (prediabetes) during which micro- and macrovascular complications may begin and progress. Furthermore, metabolic syndrome, which affects 35% of American adults confers at least a five-fold risk for T2DM. It is imperative not only to identify those with diabetes accurately, but also to identify high-risk individuals with prediabetes and metabolic syndrome. Traditionally, fasting plasma glucose (FPG) and 2-hr postprandial or post 75-gram oral glucose load values are used for the diagnosis of diabetes (the latter being more sensitive), as well as impaired fasting glucose (IFG) and impaired glucose tolerance (IGT).