scholarly journals Combined Use of Fasting Plasma Glucose and Glycated Hemoglobin A1c in a Stepwise Fashion to Detect Undiagnosed Diabetes Mellitus

2007 ◽  
Vol 213 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Tomoko Nakagami ◽  
Makoto Tominaga ◽  
Rimei Nishimura ◽  
Makoto Daimon ◽  
Toshihide Oizumi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Hemoglobin A1c ◽  
Glycated Hemoglobin ◽  
Undiagnosed Diabetes ◽  
Fasting Plasma ◽  
Glycated Hemoglobin A1c ◽  
Combined Use ◽  
Undiagnosed Diabetes Mellitus

scholarly journals GLYCATED HEMOGLOBIN (HbA1c)

2015 ◽  
Vol 22 (02) ◽  
pp. 208-214
Author(s):  
Saeed Akram Bhatti ◽  
Abdul Haseeb Khan ◽  
Naeem Yaqoob
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Detection Rate ◽  
Large Scale ◽  
Glycated Hemoglobin ◽  
Undiagnosed Diabetes ◽  
Pakistani Population ◽  
Chronic Hyperglycemia ◽  
Fasting Plasma

HbA1c gives an integrated index of glycemia over the entire 120 days lifespan of red blood cells. Therefore, measuring HbA1c would be appropriate in diagnosing adisease characterized by chronic hyperglycemia and a gradual progression to complications.Objectives: our primary objective was to evaluate the use of HbA1c as screening test forundiagnosed diabetes (WHO criteria of Fasting plasma glucose (FPG) of ≥ 7mmol/l (126mg/dl))in healthy asymptomatic individuals in Pakistani population. Study Design and Methodology:A cross sectional population survey was carried on asymptomatic, healthy individuals withoutpast history of diabetes. Venous blood was obtained to measure fasting plasma glucose(fasting > 8 hours) and Hb A1c. Place and Duration of Study: Khan lab Sargodha from July2013 to March 2014. The test: It was performed by using NycoCard HbA1c in vitro diagnosticmedical device for quantitative determination of glycated hemoglobin in whole blood. Results:In our sample size of 775, the lowest HbA1c was found to be 5% and Highest 13.2%. Arithmeticmeans was 6.7565%, while the median value was 6.2% and standard deviation 1.3323. Whenusing FPG only, the detection rate of diabetes was 32.65% (female, 14.71%; male, 17.94%).When HbA1c was included as a diagnostic test, the detection rate increased to 40% (female,18.84%; male, 21.16 %). An additional 7.6% of participants were diagnosed with diabetes whenusing HbA1c criteria. ROC (A receiver operating characteristic) curve was used for analysis.At HbA1c cutoff of ≥6.5% it demonstrated sensitivity of 98.02% (95% CI) and specificity of88.12% (95% CI) for detection of undiagnosed diabetes mellitus in healthy asymptomaticindividuals in Pakistani population. Area under the ROC curve was 0.981354 with significancelevel P (Area=0.5) 0.0001. Conclusions: Our study reveals that HbA1c is a highly specific andconvenient alternative to fasting plasma glucose for screening of diabetes mellitus in Pakistanipopulation. A large scale survey should be carried out to set our own national standardizations.

Prevalence and risk factors of undiagnosed diabetes mellitus among gastroenterological patients: a HbA1c-based single center experience

2021 ◽  
Author(s):  
Thorben Fründt ◽  
Niko Schröder ◽  
Angelique Hölzemer ◽  
Hans Pinnschmidt ◽  
Jocelyn de Heer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Cirrhosis ◽  
Risk Factor ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Medication Use ◽  
Undiagnosed Diabetes ◽  
Diabetes Screening ◽  
Fasting Plasma

Abstract Background Diabetes mellitus is a major risk factor for microvascular disease, leading to chronic kidney injury or cardiovascular disease, but there is a tremendous proportion of patients worldwide who suffer from undiagnosed diabetes. Until now, little is known about the prevalence of undiagnosed diabetes in gastroenterology inpatients. Objective To improve detection of undiagnosed diabetes, a routine screening procedure for gastroenterology inpatients, based on hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) measurement, was established. Methods We conducted a retrospective analysis of the implemented diabetes screening. Diabetes mellitus was diagnosed according to the guideline of the German Diabetes Association in patients with an HbA1c of ≥6.5% anld/or fasting plasma glucose (FPG) ≥126 mg/dL. Univariate and multivariate analyses were performed to identify independent risk factors for undiagnosed diabetes. Results Within a 3-month period, 606 patients were eligible for a diabetes screening. Pre-existing diabetes was documented in 120 patients (19.8 %), undiagnosed diabetes was found in 24 (3.9%), and 162 patients (26.7%) met the definition for prediabetes. Steroid medication use, age, and liver cirrhosis due to primary sclerosing cholangitis (PSC) were identified as risk factors for undiagnosed diabetes. Conclusion The prevalence of undiagnosed diabetes in gastroenterology inpatients is markedly elevated in comparison to the general population, and a substantial number of inpatients are in a prediabetic status, underlining the need for diabetes screening. In addition to previously described risk factors of patient age and steroid medication use, we identified PSC-related liver cirrhosis (but not liver cirrhosis due to another etiology) as an independent risk factor for undiagnosed diabetes.

scholarly journals Altered levels of fructosamine and glycated haemoglobin (HbA1c) in thyroid disorder patients without diabetes mellitus-A cross sectional study

Biomedicine ◽  
2021 ◽  
Vol 41 (1) ◽  
pp. 46-51
Author(s):  
G.Sajjan Sangamma ◽  
S. Sonoli Smita ◽  
Naveen Angadi
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glycated Hemoglobin ◽  
Thyroid Disorder ◽  
Newly Diagnosed ◽  
Fasting Plasma ◽  
Significant Difference ◽  
The Mean ◽  
Hba1c Levels

Introduction and Aim:Co-existence of thyroid disorder and Diabetes Mellitus is no more a coincidence. The cause and impact of thyroid disorder on glucose levels or vice versa is a well -established fact.Hence in this study we wanted to know the glycemic status by estimating fructosamine and glycated hemoglobin of the newly diagnosed thyroid patients without diabetes mellitus. The aim of the study was to estimatefructosamine and glycated hemoglobin levels in newly diagnosed subclinical hypothyroid, clinical hypothyroid and hyper thyroid patients without diabetes mellitus. Material and Methods:Twenty cases of subclinical hypothyroid,30 cases of hypothyroid,30 cases of hyperthyroid  and 30 healthy participantswere included in the study. Fasting plasma glucose and thyroid profile was estimated in suspected cases of thyroid disorder and participants with fasting plasma glucose (FPG) more than 110 mg/dL were excluded from the study.The participants who were eligible for an inclusion criterion were estimated for fructosamine by nitro bluetetrazolium, (NBT) method andion-exchange high performance liquid chromatography was for glycated hemoglobin. Results:In Subclinical hypothyroid group there was a statistically significant increase in the mean fasting plasma glucose, fructosamine and glycated hemoglobin levels when compared with the controls.There was a significant increase in the mean fasting plasma glucose,fructosamine and glycated hemoglobin(HbA1c) levels in clinical hypothyroid group when compared with the controls.Pairwise comparison of FPG (p=0.001), fructosamine (p=0.001) and HbA1c (p=0.001) levels with controls showed a statistically significant difference.In clinical hyperthyroid group the mean FPG and HbA1c levels were high and low fructosamine levels when compared with the controls by one way ANOVA.Pairwise comparison of FPG (p=0.001), fructosamine levels (p=0.001) and HbA1c (p=0.001) levels (p=0.001) with controls showed a statistically significant difference. Conclusion: Unidentified hyperglycemia could have an impact on thyroid disorder leading to its complication.Hence a systematic approach to fructosamine testing(monitor the plasma glucose concentration over 2–3 weeks) as a routine test in thyroid disorder patients, needs to be considered.Also the management of hyperglycemia in thyroid patients without diabetes mellitus may prove  to be beneficial.  

scholarly journals Hemoglobin A1c in combination with fasting plasma glucose trumps fasting plasma glucose alone as predictive indicators for diabetes mellitus: an ambidirectional cohort study of Thai people with impaired fasting glucose

2021 ◽  
Vol 9 (2) ◽  
pp. e002427
Author(s):  
Sangsulee Thamakaison ◽  
Thunyarat Anothaisintawee ◽  
Kanokporn Sukhato ◽  
Nattawut Unwanatham ◽  
Sasivimol Rattanasiri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cohort Study ◽  
Impaired Fasting Glucose ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Hemoglobin A1c ◽  
Fasting Glucose ◽  
Cox Regression Analysis ◽  
Fasting Plasma

IntroductionThis ambidirectional cohort study aimed to assess the performance of combining hemoglobin A1c (HbA1c) to fasting plasma glucose (FPG) for estimation of progression rate to diabetes mellitus (DM) and to explore the risk factors of DM in patients with impaired fasting glucose (IFG).Research design and methodsPatients with IFG were eligible for this study. IFG was defined as FPG of 100–125 mg/dL. Progression rates to DM were estimated using Kaplan-Meier analysis. Risk factors of DM were explored by Cox regression analysis.Results3011 patients were enrolled with median follow-up time of 8 years (range: 6 months–29 years). Progression rates to DM in patients with FPG 100–109 mg/dL and 110–125 mg/dL were 2.64 and 4.79 per 100 person-years. After adjusting covariables, compared with patients with FPG 100–109 mg/dL plus normal HbA1c (<5.7%), hazard ratios (95% CI) of patients with FPG 110–125 plus normal HbA1c, FBG 100–109 plus abnormal HbA1c (5.7%–6.49%), and FPG 110–125 plus abnormal HbA1c were 5.89 (2.37 to 14.63), 16.30 (8.59 to 30.92), and 33.84 (16.41 to 69.78), respectively. Body mass index ≥27.5 kg/m2, serum triglyceride level ≥150 mg/dL, family history of DM, and low level of high-density lipoprotein-cholesterol were independently associated with risk of DM in patients with IFG.ConclusionsPatients with both IFG and abnormal HbA1c had higher risk of DM than patients with IFG alone. Therefore, performing HbA1c in combination with FPG helps to identify subgroups of people with IFG at highest risk of DM. These patients should have the highest priority in diabetes prevention programs, especially in countries with low and limited resources.

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