HbA 1c as a screening tool for detection of Type 2 diabetes: a systematic review

Bennett, C. M.; Guo, M.; Dharmage, S. C.

doi:10.1111/j.1464-5491.2007.02106.x

Cited by 535Diabetes Management and ResearchDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and Management

HbA 1c as a screening tool for detection of Type 2 diabetes: a systematic review

Bennett, C. M., Guo, M., Dharmage, S. C.·2007·Diabetic Medicine

DOI 10.1111/j.1464-5491.2007.02106.x

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Abstract

Aim To assess the validity of glycated haemoglobin A(1c) (HbA(1c)) as a screening tool for early detection of Type 2 diabetes. Methods Systematic review of primary cross-sectional studies of the accuracy of HbA(1c) for the detection of Type 2 diabetes using the oral glucose tolerance test as the reference standard and fasting plasma glucose as a comparison. RESULTS Nine studies met the inclusion criteria. At certain cut-off points, HbA(1c) has slightly lower sensitivity than fasting plasma glucose (FPG) in detecting diabetes, but slightly higher specificity. For HbA(1c) at a Diabetes Control and Complications Trial and UK Prospective Diabetes Study comparable cut-off point of > or = 6.1%, the sensitivity ranged from 78 to 81% and specificity 79 to 84%. For FPG at a cut-off point of > or = 6.1 mmol/l, the sensitivity ranged from 48 to 64% and specificity from 94 to 98%. Both HbA(1c) and FPG have low sensitivity for the detection of impaired glucose tolerance (around 50%). CONCLUSIONS HbA(1c) and FPG are equally effective screening tools for the detection of Type 2 diabetes. The HbA(1c) cut-off point of > 6.1% was the recommended optimum cut-off point for HbA(1c) in most reviewed studies; however, there is an argument for population-specific cut-off points as optimum cut-offs vary by ethnic group, age, gender and population prevalence of diabetes. Previous studies have demonstrated that HbA(1c) has less intra-individual variation and better predicts both micro- and macrovascula…

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HbA1c effectively predicts diabetes complications.
“and effectively predicts diabetes complications (7)”
From The effectiveness of digital health intervention on glycemic control and physical activity in patients with type 2 diabetes: a systematic review and meta-analysis (2025) · cites this paper as [7]
The HbA1c test is not effective in detecting IGT.
“In addition, it is well known that the HbA1c test is not effective in detecting IGT [37].”
From A Novel Testing Model for Opportunistic Screening of Pre-Diabetes and Diabetes among U.S. Adults (2015) · cites this paper as [37]
HbA1c reflects average plasma glucose over the preceding 2 to 3 months.
“HbA1c remains the gold standard for assessing glycemic control, as it reflects average plasma glucose over the preceding 2 to 3 months (5).”
From Comparison of point‑of‑care HbA1c devices with laboratory HPLC methods: A systematic review and meta‑analysis (2026) · cites this paper as [5]

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The Value of Glycated haemoglobin A1c for the diagnosis of type 2 diabetes compared with fasting plasma glucose
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Authors: Bennett, C. M., Guo, M., & Dharmage, S. C.
Affiliations: The University of Melbourne (AU)
Corresponding author: Bennett, C. M.
ORCID: Bennett, C. M.
Dharmage, S. C.
Venue: Diabetic Medicine
Publisher: Wiley
Published: 2007-03-15
Volume: 24
Issue: 4
Pages: 333-343
ISSN: 0742-3071 (ISSN-L)
1464-5491
DOI: 10.1111/j.1464-5491.2007.02106.x
OpenAlex: W2105093768
Cited by: 534
References: 44
Citations by year: 2026: 12 · 2025: 13 · 2024: 30 · 2023: 15 · 2022: 25 · 2021: 15 · 2020: 25 · 2019: 24 · 2018: 31 · 2017: 28 · 2016: 33 · 2015: 31 · 2014: 38 · 2013: 39 · 2012: 33
FWCI: 4.65
Type: journal article
Language: en
Update notices: erratum (2007-08-21)
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Diabetic Medicine (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: glycated haemoglobin A1c, type 2 diabetes screening, fasting blood glucose, diagnostic accuracy, sensitivity and specificity, impaired glucose tolerance, cut-off values, oral glucose tolerance test, cost-effectiveness
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Male, Middle Aged, Predictive Value of Tests, Reference Standards, ROC Curve, Sensitivity and Specificity, Biomarkers, Prevalence, Likelihood Functions

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HbA 1c as a screening tool for detection of Type 2 diabetes: a systematic review

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