Applying HbA1c as the only criterion for type 2 diabetes would delay its diagnosis

Original articles - Vol.26 N.6  november-december 2010
S. González-Sánchez¹, C. DePrado-Lacueva², V. Salido-Valencia³, M. Castelló-Alonso⁴, M. Gibrat-Pineda⁵, M. Mata⁶

 Author Affiliations

Abstract

Introduction: In 2010 the American Diabetes Association introduced the value of HbA1c at ≥6.5% for the diagnosis of diabetes. The impact of its implementation in the Mediterranean population is unknown. Objective: To determine how many patients would not be diagnosed and how long diagnosis of diabetes would be delayed if only HbA1c was applied. Material and methods: Retrospective study with 598 type 2 diabetes mellitus (T2DM) patients diagnosed between 1991 and 2000 in an urban primary healthcare centre. Patients without HbA1c during the 3 months after diagnosis were excluded. Included patients were reclassified by HbA1c (<5.7% normoglycaemic, 5.7-6.4% risk category and ≥6.5 diabetes), globally and by diagnostic method (glycaemia ≥140 mg/dL, glycaemia ≥126 mg/dL and oral glucose tolerance test). The period between diagnosis and the first HbA1c ≥6.5% in patients with an HbA1c <6.5% was calculated. Results: 377 patients were included, 17 (4.5%) were reclassified as normoglycaemic, 87 (23.1%) as diabetes risk category and 273 (72.4%) as diabetics. Only 52.7% of patients diagnosed with glycaemia ≥126 mg/dL were considered diabetics. Mean time to the first HbA1c ≥6.5% was 3.40 (standard deviation [SD] 2.35) years, while for normoglycaemic patients it was 3.80 (SD 2.49) years and 3.33 (SD 2.34) years for the risk category. Conclusions: The use of HbA1c as a single criterion could delay diagnosis of T2DM in almost half of cases. It seems appropriate to maintain plasma glucose as the main criteria and HbA1c as an additional criteria.

Correspondence

Correspondencia:

Sandra González Sánchez. Mar, s/n. 08930 Sant Adrià de Besos (Barcelona).

Correo electrónico:sgonzasa11@yahoo.es

 

Keywords

type 2 diabetes mellitus glycosylated hemoglobin Diagnostic methods

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