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Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes
Open accessAbstract
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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Metadata
- 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
- PMC
- PMC2540244
- 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
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- 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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