Low positive predictive value of hemoglobin A1c for diagnosis of prediabetes in clinical practice
Abstract
Background Positive predictive value (PPV) of hemoglobin A1c (HbA1c) for diagnosis of prediabetes in clinical practice has not been well studied.Methods In a prospective study, patients diagnosed with prediabetes based on HbA1c (5.7%-6.4%) underwent a 75-g oral glucose tolerance test (OGTT) as the gold standard test to diagnose dysglycemia. Demographics, anthropometrics, comorbidity, concomitant prescription medications and biochemical data were collected.Results We identified 66 patients with HbA1c-based prediabetes with a mean HbA1c of 6.00 ± 0.20%. However, based on the OGTT, 32 had normal glucose tolerance (NGT), 26 had prediabetes and 8 had diabetes yielding a PPV of HbA1c of 39.4%. In univariate analysis, the patients with the OGTT-based prediabetes administered more medications for associated medical problems compared with the NGT group (5.9 ± 2.2 versus 2.6 ± 1.8, P < 0.0001). After adjustment for baseline variables, the medication use remained significantly different between OGTT-based prediabetes and NGT groups (P = 0.041).Conclusions PPV of HbA1c for diagnosis of prediabetes in clinical setting is low. Patients with HbA1c of 5.7% to 6.4% should undergo OGTT to confirm diagnosis of dysglycemia.
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Studies have shown poor correlations between HbA1c and IFG/IGT.
“Studies have shown poor correlations between HbA1c and IFG/IGT (Gosmanov 2014; Selvin 2011).”
From Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus (2017) · cites this paper as Gosmanov 2014
The various glycaemic tests do not seem to identify the same people.
“Moreover, the various glycaemic tests do not seem to identify the same people (Gosmanov 2014; Selvin 2011).”
From Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus (2017) · cites this paper as Gosmanov 2014
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- Authors
- Gosmanov, A. R., & Wan, J.
- Affiliations
- University of Tennessee Health Science Center (US)
- Corresponding author
- Gosmanov, Aidar R.
- Venue
- The American Journal of the Medical Sciences
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 348
- Issue
- 3
- Pages
- 191-194
- ISSN
- 0002-9629 (ISSN-L)
- OpenAlex
- W2035330998
- Cited by
- 35
- References
- 25
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 4 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 3 · 2016: 6 · 2015: 2 · 2014: 1
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of the Medical Sciences (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- HbA1c, prediabetes, positive predictive value, oral glucose tolerance test, diagnostic accuracy, medication use
- MeSH terms
- Adult, Aged, Blood Glucose, Cross-Sectional Studies, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Male, Middle Aged, Prediabetic State, Predictive Value of Tests, Prospective Studies, Biomarkers
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