HbA1c in diagnosing and predicting Type 2 diabetes in impaired glucose tolerance: the Finnish Diabetes Prevention Study

• Published in: Diabetic medicine 2011-01, Vol.28 (1), p.36-42
• Main Authors: Pajunen, P., Peltonen, M., Eriksson, J. G., Ilanne-Parikka, P., Aunola, S., Keinänen-Kiukaanniemi, S., Uusitupa, M., Tuomilehto, J., Lindström, J.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Diabetes. Impaired glucose tolerance; diagnosis; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; glycated haemoglobin; impaired glucose tolerance; Medical sciences; Type 2 diabetes; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2010.03183.x

Diabet. Med. 28, 36–42 (2011) Aims  We analysed the Finnish Diabetes Prevention Study data in order to evaluate how the new HbA1c‐based criterion compares with the oral glucose tolerance test in diagnosing Type 2 diabetes among high‐risk individuals during a prospective average follow‐up of 4 years. Methods  In the Diabetes Prevention Study, 172 men and 350 women who were overweight and had impaired glucose tolerance at baseline were randomized into an intensive lifestyle intervention or a control group. The oral glucose tolerance test and HbA1c measurements were performed annually until the diagnosis of diabetes using the World Health Organization 1985 criteria. Results  The sensitivity of the HbA1c≥ 6.5% (≥ 48 mmol/mol) as a diagnostic criterion for Type 2 diabetes was 35% (95% CI 24%, 47%) in women and 47% (95% CI 31%, 64%) in men compared with diagnosis based on two consecutive oral glucose tolerance tests. The corresponding sensitivities for HbA1c≥ 6.0% (≥ 42 mmol/mol) were 67% (95% CI 55%, 77%) and 68% (95% CI 51%, 82%). The participants with HbA1c≥ 6.5% (≥ 48 mmol/mol) and diabetes based on the oral glucose tolerance test were more obese and had higher fasting glucose and 2‐h glucose concentrations than those who had a diabetic oral glucose tolerance test but HbA1c