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Vol 3, No 2 (2014)
Original articles (submitted)
Published online: 2014-05-14
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Evaluation of the usefulness of HbA1c measurement for diagnosing diabetes in a selected sample of the Polish population

Krzysztof Strojek, Małgorzata Maria Potyralska
Diabetologia Kliniczna 2014;3(2):51-56.

open access

Vol 3, No 2 (2014)
Original articles (submitted)
Published online: 2014-05-14

Abstract

Introduction. Since January 2010, the American Diabe­tes Association has been recommending, apart from hitherto applied methods, the use of glycated haemo­globin concentration as one of the diagnostic criteria for diabetes, with a limit value HbA1c ≥ 6.5%. The aim of the study was to evaluate the usefulness of HbA1c measurement for diagnosing diabetes in a selected sample of the Polish population, and to attempt to determine a cut-off point for HbA1c concentration de­fining diagnosis of diabetes, based on the examination of patients with risk factors of type 2 diabetes.

Material and method. Examinated 219 individuals (in this 142 women) in age 40–85 years, BMI 20–50 kg/m2, with one of the risk factors for diabetes, sine previously diagnosed diabetes. All participants underwent the oral glucose tolerance test (75 g glucose); blood sam­ples were taken to determine HbA1c levels by means of A1cNow+ (Bayer). In addition, in 85 randomly selected individuals, HbA1c concentration was concomitantly determined by means of high-performance liquid chromatography (HPLC).

Results. Diabetes was diagnosed in 22 individuals on the basis of the following criteria: fasting glyca­emia ≥ 126 mg/dl or glycaemia ≥ 200 mg/dl in 120th minute of OGTT test. It was demonstrated that at the cut-point HbA1c ≥ 5.7% the highest sum of sensiti­vity and specificity was achieved (sensitivity 77.3%, specificity 55.8%). For higher HbA1c values, sensitivity was gradually decreasing, whereas specificity was increasing (e.g. for HbA1c ≥ 6.1% sensitivity decreased to 36.4%, whereas specificity increased to 86.3%; for HbA1c ≥ 6.6% sensitivity and specificity values were 13.6% and 95,9%, respectively).

Conclusion. A large range of values for sensitivity and specificity indicates a low usefulness of HbA1c determination for diagnosing diabetes. The achieved “cut-off point” for obtaining the highest sensitivity and specificity is below the reference values, which is an additional argument against introduction of HbA1c determination in diabetes diagnostics.

Abstract

Introduction. Since January 2010, the American Diabe­tes Association has been recommending, apart from hitherto applied methods, the use of glycated haemo­globin concentration as one of the diagnostic criteria for diabetes, with a limit value HbA1c ≥ 6.5%. The aim of the study was to evaluate the usefulness of HbA1c measurement for diagnosing diabetes in a selected sample of the Polish population, and to attempt to determine a cut-off point for HbA1c concentration de­fining diagnosis of diabetes, based on the examination of patients with risk factors of type 2 diabetes.

Material and method. Examinated 219 individuals (in this 142 women) in age 40–85 years, BMI 20–50 kg/m2, with one of the risk factors for diabetes, sine previously diagnosed diabetes. All participants underwent the oral glucose tolerance test (75 g glucose); blood sam­ples were taken to determine HbA1c levels by means of A1cNow+ (Bayer). In addition, in 85 randomly selected individuals, HbA1c concentration was concomitantly determined by means of high-performance liquid chromatography (HPLC).

Results. Diabetes was diagnosed in 22 individuals on the basis of the following criteria: fasting glyca­emia ≥ 126 mg/dl or glycaemia ≥ 200 mg/dl in 120th minute of OGTT test. It was demonstrated that at the cut-point HbA1c ≥ 5.7% the highest sum of sensiti­vity and specificity was achieved (sensitivity 77.3%, specificity 55.8%). For higher HbA1c values, sensitivity was gradually decreasing, whereas specificity was increasing (e.g. for HbA1c ≥ 6.1% sensitivity decreased to 36.4%, whereas specificity increased to 86.3%; for HbA1c ≥ 6.6% sensitivity and specificity values were 13.6% and 95,9%, respectively).

Conclusion. A large range of values for sensitivity and specificity indicates a low usefulness of HbA1c determination for diagnosing diabetes. The achieved “cut-off point” for obtaining the highest sensitivity and specificity is below the reference values, which is an additional argument against introduction of HbA1c determination in diabetes diagnostics.

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Keywords

diabetes, glicated hemoglobin, diagnosis, polish population

About this article
Title

Evaluation of the usefulness of HbA1c measurement for diagnosing diabetes in a selected sample of the Polish population

Journal

Clinical Diabetology

Issue

Vol 3, No 2 (2014)

Pages

51-56

Published online

2014-05-14

Bibliographic record

Diabetologia Kliniczna 2014;3(2):51-56.

Keywords

diabetes
glicated hemoglobin
diagnosis
polish population

Authors

Krzysztof Strojek
Małgorzata Maria Potyralska

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