Cited by 484Diabetes Management and ResearchDiabetes, Cardiovascular Risks, and LipoproteinsChronic Kidney Disease and Diabetes

Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes

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McCane, D R, Hanson, R L, Charles, M A, Jacobsson, L T H, Pettitt, D Dj, Bennett, P H, Knowler, W C·1994·BMJ

Abstract

Objective : To compare the ability of tests measuring two hour plasma glucose, fasting plasma glucose, and glycated haemoglobin concentrations in predicting the specific microvascular complications of non-insulin dependent diabetes mellitus. Design : Cross sectional and longitudinal analysis of the relation between complications and concomitant results of the three tests. Setting : Gila River Indian Community, Arizona. Subjects : Pima Indians (cross sectional, n=960),aged 25 years or above who were not receiving insulin or oral hypoglycaemic treatment at the baseline examination. Main outcome measures : Development of retinopathy and nephropathy. Results : Cross sectionally, frequency distributions of logarithms of the three sets of results were bimodal, with the prevalence of retinopathy and nephropathy being, respectively, 12.0-26.7 and 3.9-4.2 times as high above as below cut off points which minimised overlap (two hour plasma glucose concentration 12.6 mmol/l; fasting plasma glucose concentration 9.3mmol/l; glycated haemoglobin (HbA1c) concentration 7.8%). Longitudinally, each of the three measures of glycaemia significantly predicted the development of retinopathy (P<0.0001) and nephropathy (P<0.05). Receiver operating characteristic curves showed that two hour plasma glucose concentration was superior to fasting plasma glucose concentration (P<0.05) for prevalent cases of retinopathy, but otherwise no variable had a significant advantage for detecting incident or prevalent cases of either complication. Conclusions : These findings suggest that determination of glycated haemoglobin or fasting plasma glucose concentrations alone may be acceptable alternatives to measuring glucose concentration two hours after challenge with 75 g glucose for the diagnosis of diabetes.

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Crossref · 10.1136/bmj.308.6940.1323

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Authors
McCane, D. R., Hanson, R. L., Charles, M. A., Jacobsson, L. T. H., Pettitt, D. D., Bennett, P. H., & Knowler, W. C.
Affiliations
National Institute of Diabetes and Digestive and Kidney Diseases (US)
Venue
BMJ
Publisher
BMJ
Published
1994-05-21
Volume
308
Issue
6940
Pages
1323-1328
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
OpenAlex
W2054652204
Cited by
484
References
45
Citations by year
2026: 5 · 2025: 2 · 2024: 8 · 2023: 5 · 2022: 10 · 2021: 13 · 2020: 11 · 2019: 7 · 2018: 12 · 2017: 12 · 2016: 18 · 2015: 21 · 2014: 11 · 2013: 24 · 2012: 19
FWCI
5.86
Type
journal article
Language
en
Open access
Locations
  • BMJ (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (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 › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
HbA1c, fasting blood glucose, diabetes diagnosis, type 2 diabetes, diabetic retinopathy, diabetic nephropathy, microvascular complications, Pima Indians, diagnostic test comparison
MeSH terms
Adult, Aged, Blood Glucose, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Diabetic Retinopathy, Fasting, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Indians, North American, Longitudinal Studies, Male, Middle Aged, Incidence, Prevalence

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