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

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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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The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105033441801 · Cited by 10,873
Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes
(2005) · New England Journal of Medicine · doi:10.1056/nejmoa052187 · Cited by 5,138
Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study
Pan, X.-R., Li, G.-W., Hu, Y.-H., Wang, J.-X., Yang, W.-Y., An, Z.-X., Hu, Z.-X., Juan-Lin, Xiao, J.-Z., Cao, H.-B., et al. (1997) · Diabetes Care · doi:10.2337/diacare.20.4.537 · Cited by 4,320
Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study
Adler, A. I. (2000) · BMJ · doi:10.1136/bmj.321.7258.412 · Cited by 2,133
Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus
Sacks, D. B., Arnold, M., Bakris, G. L., Bruns, D. E., Horvath, A. R., Kirkman, M. S., Lernmark, A., Metzger, B. E., & Nathan, D. M. (2011) · Clinical Chemistry · doi:10.1373/clinchem.2010.161596 · Cited by 1,360
Onset of NIDDM occurs at Least 4–7 yr Before Clinical Diagnosis
Harris, M. I., Klein, R., Welborn, T. A., & Knuiman, M. W. (1992) · Diabetes Care · doi:10.2337/diacare.15.7.815 · Cited by 1,306
Association of Hemoglobin A 1c with Cardiovascular Disease and Mortality in Adults: The European Prospective Investigation into Cancer in Norfolk
Khaw, K.-T., Wareham, N., Bingham, S., Luben, R., Welch, A., & Day, N. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-6-200409210-00006 · Cited by 974
IFCC reference system for measurement of hemoglobin A1c in human blood and the national standardization schemes in the United States, Japan, and Sweden: a method-comparison study
Hoelzel, W., Weykamp, C., Jeppsson, J.-O., Miedema, K., Barr, J. R., Goodall, I., Hoshino, T., John, W. G., Kobold, U., Little, R., et al. (2004) · Clinical Chemistry · doi:10.1373/clinchem.2003.024802 · Cited by 690
Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes
McCane, D. R., Hanson, R. L., Charles, M. A., Jacobsson, L. T. H., Pettitt, D. D., Bennett, P. H., & Knowler, W. C. (1994) · BMJ · doi:10.1136/bmj.308.6940.1323 · Cited by 484
Screening for Type 2 Diabetes
American Diabetes Association (2004) · Diabetes Care · doi:10.2337/diacare.27.2007.s11 · Cited by 443
A Clinical Approach for the Diagnosis of Diabetes Mellitus
Peters, A. L. (1996) · JAMA · doi:10.1001/jama.1996.03540150048030 · Cited by 376
Comparison of fasting and 2-hour glucose and HbA1c levels for diagnosing diabetes. Diagnostic criteria and performance revisited
Engelgau, M. M., Thompson, T. J., Herman, W. H., Boyle, J. P., Aubert, R. E., Kenny, S. J., Badran, A., Sous, E. S., & Ali, M. A. (1997) · Diabetes Care · doi:10.2337/diacare.20.5.785 · Cited by 325
A clinical approach for the diagnosis of diabetes mellitus: an analysis using glycosylated hemoglobin levels. Meta-analysis Research Group on the Diagnosis of Diabetes Using Glycated Hemoglobin Levels
Peters, A. L. (1996) · JAMA · doi:10.1001/jama.276.15.1246 · Cited by 291
Biological Variation in HbA1c Predicts Risk of Retinopathy and Nephropathy in Type 1 Diabetes
McCarter, R., Hempe, J. M., Gómez, R., & Chalew, S. A. (2004) · Diabetes Care · doi:10.2337/diacare.27.6.1259 · Cited by 285
Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies
The DECODE-study group on behalf of the (1999) · Diabetologia · doi:10.1007/s001250051211 · Cited by 227
Tests of Glycemia for the Diagnosis of Type 2 Diabetes Mellitus
Barr, R. G., Nathan, D. M., Meigs, J., & Singer, D. E. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-4-200208200-00011 · Cited by 219
Prevalence and prediction of unrecognised diabetes mellitus and impaired glucose tolerance following acute stroke
Gray, C. S., Scott, J., FRENCH, J. M., Alberti, K. G. M. M., & O’Connell, J. (2003) · Age and Ageing · doi:10.1093/ageing/afh026 · Cited by 163
HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose
Perry, R. C., Shankar, R. R., Fineberg, N., McGill, J., & Baron, A. D. (2001) · Diabetes Care · doi:10.2337/diacare.24.3.465 · Cited by 150
Mean Blood Glucose and Biological Variation Have Greater Influence on HbA1c Levels Than Glucose Instability
McCarter, R., Hempe, J. M., & Chalew, S. A. (2006) · Diabetes Care · doi:10.2337/diacare.29.02.06.dc05-1594 · Cited by 124
Combined Use of a Fasting Plasma Glucose Concentration and HbA1c or Fructosamine Predicts the Likelihood of Having Diabetes in High-Risk Subjects
Ko, G. T. C., Chan, J. C. N., Yeung, M. W., Chow, C., Tsang, L. W. W., Li, J. K. Y., So, W.-Y., Wai, H. P. S., & Cockram, C. S. (1998) · Diabetes Care · doi:10.2337/diacare.21.8.1221 · Cited by 120
Clinical significance of targeting postprandial and fasting hyperglycemia in managing type 2 diabetes mellitus
Fonseca, V. A. (2003) · Current Medical Research and Opinion · doi:10.1185/030079903125002351 · Cited by 108
Correlation among fasting plasma glucose, two-hour plasma glucose levels in OGTT and HbA1c
Ito, C., Maeda, R., Ishida, S., Sasaki, H., & Harada, H. (2000) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(00)00187-x · Cited by 103
Screening for Type 2 Diabetes and Impaired Glucose Metabolism
Colagiuri, S., Hussain, Z., Zimmet, P., Cameron, A., & Shaw, J. (2004) · Diabetes Care · doi:10.2337/diacare.27.2.367 · Cited by 100
Global Harmonization of Hemoglobin A1c
Sacks, D. B. (2005) · Clinical Chemistry · doi:10.1373/clinchem.2004.047431 · Cited by 94
Macrovascular Risk and Diagnostic Criteria for Type 2 Diabetes
Jesudason, D. R., Dunstan, K., Leong, D., & Wittert, G. A. (2003) · Diabetes Care · doi:10.2337/diacare.26.2.485 · Cited by 77
Diagnostic Strategies to Detect Glucose Intolerance in a Multiethnic Population
Anand, S. S., Razak, F. A., Vuksan, V., Gerstein, H. C., Malmberg, K., Yi, Q., Teo, K. K., & Yusuf, S. (2003) · Diabetes Care · doi:10.2337/diacare.26.2.290 · Cited by 75
Haemoglobin A1c: Analysis and Standardisation
John, W. G. (2003) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2003.184 · Cited by 72
Combined use of fasting plasma glucose and HbA1c predicts the progression to diabetes in Chinese subjects.
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Fasting plasma glucose and glycated haemoglobin in the screening of diabetes and impaired glucose tolerance
Mannucci, E., Ognibene, A., Sposato, I., Brogi, M., Gallori, G., Bardini, G., Cremasco, F., Messeri, G., & Rotella, C. M. (2003) · Acta Diabetologica · doi:10.1007/s00592-003-0109-8 · Cited by 61
Projected Impact of Implementing the Results of the Diabetes Prevention Program in the U.S. Population
Saydah, S., Byrd-Holt, D. D., & Harris, M. I. (2002) · Diabetes Care · doi:10.2337/diacare.25.11.1940 · Cited by 50
New data on the rate of progression of impaired glucose tolerance to NIDDM and predicting factors.
Heine, R. J., Nijpels, G., & Mooy, J. M. (1996) · PubMed · Cited by 45
Using HbA1c to Improve Efficacy of the American Diabetes Association Fasting Plasma Glucose Criterion in Screening for New Type 2 Diabetes in American Indians
Wang, W., Lee, E. T., Fabsitz, R. R., Welty, T. K., & Howard, B. V. (2002) · Diabetes Care · doi:10.2337/diacare.25.8.1365 · Cited by 43
Usefulness of stable HbA1c for supportive marker to diagnose diabetes mellitus in Japanese subjects
Tanaka, Y., Atsumi, Y., Matsuoka, K., Mokubo, A., Asahina, T., Hosokawa, K., Shimada, S., Matsunaga, H., Takagi, M., Ogawa, O., et al. (2001) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(01)00226-1 · Cited by 43
Glycated haemoglobin predicts progression to diabetes mellitus in Pima Indians with impaired glucose tolerance
Little, R. R., England, J. D., Wiedmeyer, H. M., Madsen, R. W., Pettitt, D. J., Knowler, W. C., & Goldstein, D. E. (1994) · Diabetologia · doi:10.1007/bf00398051 · Cited by 43
Diagnostic value of fasting capillary glucose, fructosamine and glycosylated haemoglobin in detecting diabetes and other glucose tolerance abnormalities compared to oral glucose tolerance test
Herdzik, E., Safranow, K., & Ciechanowski, K. (2002) · Acta Diabetologica · doi:10.1007/s005920200007 · Cited by 41
Evaluation of Capillary Collection System for HbA1c Specimens
Voss, E. M., Cembrowski, G. S., Clasen, B. L., Spencer, M. L., Ainslie, M. B., & Haig, B. (1992) · Diabetes Care · doi:10.2337/diacare.15.5.700 · Cited by 28
Glycated haemoglobin assays. Approaches to standardization of results
Stott, A., Casson, I. F., & Higgins, G. (2001) · Diabetic Medicine · doi:10.1046/j.1464-5491.2001.00462.x · Cited by 22
A Rational Alternative for the Diagnosis of Diabetes Mellitus in High Risk Individuals
Tavintharan, S., Chew, L., & Heng, D. (2000) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.v29n2p213 · Cited by 21
Calibration of HbA 1c and its measurement in the presence of variant haemoglobins: report on questionnaire to manufacturers
Manley, S. E., ROUND, R. A., & Smith, J. M. (2006) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1258/000456306776021508 · Cited by 16
The number of unexpected HbA1c variants may be a greater problem in routine practice than is generally realized
Reynolds, T., Twomey, P. J., Harvey, T., & Green, B. N. (2004) · Diabetic Medicine · doi:10.1111/j.1464-5491.2004.01278.x · Cited by 12
Untitled work
Alberti (1998) · doi:10.1002/(sici)1096-9136(199807)15:7

Research works printed but not linked: 1

Little RR, 1998, A simple blood collection device for analysis of glycohemoglobin (GHB), Clin Chem, 44, A

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The 2015 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension
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See all 535

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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