Fasting plasma glucose diagnostic criterion, proposed by the American Diabetes Association, has low sensitivity for diagnoses of diabetes in Mexican population

• Published in: Journal of diabetes and its complications 2001-07, Vol.15 (4), p.171-173
• Main Authors: Rodrı́guez-Morán, Martha, Guerrero-Romero, Fernando
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood Chemical Analysis - standards; Blood Glucose - analysis; Blood Glucose - metabolism; Body Height; Body Weight; Cross-Sectional Studies; Diabetes Mellitus - blood; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus, Type 2 - diagnosis; Diagnoses; Fasting; Fasting plasma glucose; Female; Functional investigation of endocrine glands and genital system; Glucose Tolerance Test; Guidelines as Topic; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Mexico - epidemiology; Middle Aged; Non insulin-dependent diabetes mellitus; Reference Values; Reproducibility of Results; ROC Curve; Sensitivity; Sensitivity and Specificity; United States; Voluntary Health Agencies
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/S1056-8727(01)00150-7

To determine the best cutoff value of fasting plasma glucose (FPG) for diagnosis of diabetes, using the 2-h postglucose load (2-h PG) as the gold standard, in Mexican population and compare it to the 7.0 mmol/l limit proposed by the American Diabetes Association (ADA). 712 apparently healthy Mexican individuals were included in a cross-sectional randomized population survey. Sensitivity of FPG criterion for diagnoses of type 2 diabetes was calculated from a fourfold table. Glycemia value 2-h PG of ≥11.1 mmol/l was the “gold standard” diagnostic test. The optimal FPG value for diagnoses of diabetes was established on a receiver operating characteristic (ROC) scatter plot. On the basis of the “gold standard” diagnostic test, diagnosis of type 2 diabetes was established in 65 (9.12%) subjects, whereas the ADA FPG diagnostic criterion only identified 39 (5.47%) subjects; that is a sensitivity of 60% (CI 95% 47.1–72.0). The ROC scatter plot showed the best cutoff value of FPG for diagnoses of diabetes that corresponds to 6.1 mmol/l, which has the highest sensitivity (0.985). FPG diagnostic criterion proposed by the ADA Expert Committee for diagnosis of type 2 diabetes has low sensitivity in Mexican population. For epidemiological purposes, estimates of diabetes prevalence in Mexico based on a FPG value of ≥6.1 mmol/l will improve the success of the screening.