Role of Glycated Hemoglobin in the Diagnosis of Diabetes Mellitus and Pre-diabetes (original) (raw)
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International journal of preventive medicine, 2013
A highly standardized screening test for newly diagnosis diabetes and pre-diabetes is necessary. the study goal was to clarify the power and efficacy of glycated hemoglobin (HbA1c) in the diagnosis of diabetes and pre-diabetes by comparing against the other American Diabetes Association (ADA) diagnostic criteria of fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT). This is a retrospective study. A total of 27,001 individuals attended to the internal medicine outpatient clinic between 2006 and 2010 years were screened. All diabetic patients and those using drugs associated with the development of diabetes were excluded. The results of FPG, OGTT and HbA1c for 1814 individual were analyzed and all grouped as diabetic patients, glucose intolerant (pre-diabetes) patients and non-diabetic patients according to new ADA criteria for the diagnosis of diabetes. The prevalence of newly diagnosed diabetes was 69.6% and 54% by using HbA1c alone, 64.2% and 28.2% with 2-h OGTT al...
Role of Glycated Hemoglobin in the Diagnosis of Diabetes Mellitus
2008
Objective: To evaluate glycated hemoglobin as a marker for diagnosis of diabetes mellitus.Design: Comparative cross-sectional studyPlace and Duration of Study: This study was carried out between July 2005 to April 2006 at department of chemical pathology and endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi.Subjects and Methods: Subjects (n=104) demonstrating impaired glucose regulation at the endocrine clinic of AFIP were selected. Forty seven age and sex matched normoglycemic healthy looking controls were also included in the study. Samples under complete medical fasting state were collected for glucose and glycated hemoglobin analysis, and then samples were collected at 1 hour and 2 hour for plasma glucose as part of oral glucose tolerance testing (OGTT). These subjects were later stratified to have all the disease ranges in terms of severity by 75 g OGTT results into following groups: Group-1: Controls, Group-2: Subjects with impaired fasting glucose (IFG), bu...
Glycated Hemoglobin (HbA1c) -A Predictor of Glycemic Control and Diabetes Mellitus
https://www.ijhsr.org/IJHSR\_Vol.9\_Issue.3\_March2019/IJHSR\_Abstract.02.html, 2019
Diabetes mellitus is a global problem and is on the increase in all walks of life .The increase prevalence of Diabetes mellitus type 2 is going to be the most in Asia in the next decade. The HbA1c level is currently one of the best ways to diagnose Diabetes mellitus. Level of HbA1c is in use to check glycemic control in diabetic and pre diabetic patients. Physicians provide treatment regime to reduce the risk associated with the development and progression of chronic complications of diabetes. HbA1c is taken to represent the glycemic control from few weeks to months. The majority of the diabetic patients in the present study show poor or uncontrolled with respect to HbA1c (>7%). The measurement of HbA1c is by HPLC method .Hence the interference by abnormal hemoglobin will be eliminated. However hemoglobin turnover rate should be taken into consideration. The risk for developing complications of Diabetes mellitus is high in the study group which warrants immediate preventive measures to reduce HbA1c level and thereby the onset of Diabetes mellitus.
International Journal of Research in Medical Sciences, 2015
Type 2 Diabetes Mellitus is one of the leading causes of the morbidity and mortality worldwide. There is an estimated 382 million people with diabetes worldwide in the year 2013 out of which 65.1 million are from India. 1 American Diabetes Association guidelines of 2010 have incorporated HbA1c as a diagnostic criterion for Diabetes Mellitus. 2 Glycated haemoglobin is formed by post translational, non enzymatic, substrate concentration dependent irreversible process and HbA1c is the sub fraction of glycated normal Haemoglobin. Several factors like hemoglobinopathies, renal failure, use of different drugs and even laboratory error will influence the accuracy of HbA1c. 3 Evidence suggests that HbA1c has geographic and ethnic variability independent of glycaemic status. 2 This may be ABSTRACT Background: Prevalence of Type 2 Diabetes Mellitus in Indian population is on rise and is leading to significant morbidity and mortality. The revised ADA guidelines since 2010 have suggested glycated haemoglobin (HbA1c) as a diagnostic test for Type 2 diabetes. HbA1c level is having geographic and ethnic variability independent of glycaemic status and this has not been extensively studied in many regions. Objective: To study the characteristics of HbA1C in the South Indian population and to determine the cut off value for HbA1C in diagnosing Diabetes in them. Methods: This is a hospital based observational study conducted at a Tertiary care centre in North Kerala. Patients with age ≥30yrs with Fasting Plasma Glucose (FPG) ≥ 100 or Random Plasma Glucose (RPG) ≥ 200 with symptoms of hyperglycaemia with no previous history of anti diabetic treatment were selected for the study. A preset questionnaire was used to collect the data which was later analysed using relevant statistical techniques. Results: Out of the consecutive diabetic patients attending medicine OPD 99 newly detected diabetics/prediabetics who were not under any anti diabetic medications were studied. New onset diabetes/prediabetes patients showed a mean HbA1c of 8.26(SD=2.31). There was no significant correlation of HbA1c values with age, sex and duration of diabetes in the study population. The HbA1c values also had no significant correlation with systolic blood pressure, total cholesterol values or triglyceride levels. However it was significantly related to Fasting plasma glucose, Post prandial plasma glucose and serum LDL cholesterol values. In newly detected diabetic patients (with FPG≥126 taken as gold standard) ROC analysis determined a HbA1c cut off at 6.45% (AUC=0.76, sensitivity=79%, specificity=60%). Conclusion: The study provides a reliable cutoff of glycated haemoglobin (6.45%) among South Indian population which is in accordance with the ADA recommendations.
GLYCATED HAEMOGLOBIN HbA1c FOR DIAGONOSIS OF DIABETES MELLITUS
Glycated Hemoglobin (HbA1c) gives an estimate of long-term average glycemic status. It is used routinely to assess glycemic control in diabetics to attain treatment goals and prevent long term complications. Its recommendation for diagnosis of diabetes mellitus has evoked mixed response worldwide. We reviewed a number of published articles to analyze the pros and cons of using HbA1c for diagnosis of Diabetes mellitus in India. We observed that though HbA1c has some indisputable advantages over fasting plasma glucose estimation for diagnosing diabetes mellitus, a number of biochemical, clinical and economical factors limit its use as single diagnostic agent. Diagnostic methods and laboratories are insufficiently standardized for HbA1c in India. The clinician must consider the overall patient profile in addition to a number of local variations and disorders especially hemoglobinopathies /anemias before accepting an abnormal HbA1c value. Supportive or repeat tests may be required leading to increase in cost and delay in diagnosis. In the present Indian scenario, especially the fragmented unorganized health care sector in suburban areas, HbA1c cannot be accepted as a sole and independent test to diagnose diabetes mellitus.
The Indian journal of medical research, 2016
Glycosylated haemoglobin (HbA 1c ) has been in use for more than a decade, as a diagnostic test for type 2 diabetes. Validity of HbA 1c needs to be established in the ethnic population in which it is intended to be used. The objective of this study was to derive and validate a HbA 1c cut-off value for the diagnosis of type 2 diabetes in the ethnic population of Rayalaseema area of south India. In this cross-sectional study, consecutive patients suspected to have type 2 diabetes underwent fasting plasma glucose (FPG) and 2 h post-load plasma glucose (2 h-PG) measurements after a 75 g glucose load and HbA 1c estimation. They were classified as having diabetes as per the American Diabetes Association criteria [(FPG ≥7 mmol/l (≥126 mg/dl) and/or 2 h-PG ≥11.1 mmol/l (≥200 mg/dl)]. In the training data set (n = 342), optimum cut-off value of HbA 1c for defining type 2 diabetes was derived by receiver-operator characteristic (ROC) curve method using oral glucose tolerance test results as g...
Glycated Hemoglobin (HBA1C) as a Diagnostic Marker for Diagnosis of Diabetes
2021
Glycated hemoglobin (glycohemoglobin, HbA1c, hemoglobin A1c, A1c, or less commonly HbA1c, HgbA1c, Hb1c, etc.) is a form of hemoglobin (Hb) that is chemically linked to a sugar. Most monosaccharides, including glucose, galactose and fructose, spontaneously (i.e. non-enzymatically) bond with hemoglobin, when present in the bloodstream of humans. This cross-sectional study was conducted among the patients presenting in the medical outdoor department of different hospitals. Name, age, gender and HbA1c levels were noted on a predefined proforma. All the data was entered and analyzed with SPSS Ver. 23.0. The quantitative variables were presented as mean and standard deviation. The qualitative variables were presented as frequency and percentages. A total of 60 patients were included in this study i.e., 30 males (50%) and 30 females (50%). The mean age of the patients was 34.32±5.50 years. Out of 60 patients, five patients had HbA1c values of >6.5% and the patients were labelled as diab...
Pakistan Armed Forces Medical Journal, 2018
Objective: To determine median HbA1c level in patients screened for DM and compare the diagnostic accuracyof HbA1c with the currently recommended ADA cut off, using 2 hours (h) plasma glucose (2-h PG) post 75 gramsoral glucose tolerance test (OGTT) as gold standard.Study Design: Cross sectional study.Place and Duration of Study: Aga Khan University Hospital Karachi, from Jul 2014 to Nov 2015.Patients and Methods: Consecutive subjects screened by OGTT for diabetes mellitus (DM) were included. Bloodsample for plasma glucose and HbA1c were analyzed on ADVIA 1800.Results: Total 146 subjects were included with median age 45 (IQR 54.2-35) years; 53% (n=77) being females.Median HbA1c of the study subjects was 6% (IQR 6.6-5.6). Positive correlation was observed between age andHbA1c [5.7% (IQR 6.2-5.3) 40 y subjects; r 0.34, p=0.000). Males had higher HbA1cthan females [6.1% (IQR 6.8-5.7) years. 5.9% (IQR 6.4-5.4); r 0.17, p=0.036). HbA1c levels were significantlydifferent amongst the differ...
The Professional Medical Journal
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,...