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Cited by 199Diabetes Management and ResearchDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and Management

Relationship Between A1C and Glucose Levels in the General Dutch Population

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van 't Riet, Esther, Alssema, Marjan, Rijkelijkhuizen, Josina M., Kostense, Piet J., Nijpels, Giel, Dekker, Jacqueline M.·2010·Diabetes Care
DOI 10.2337/dc09-0677PMC PMC2797987
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Abstract

OBJECTIVE: To investigate the relationship among A1C, fasting plasma glucose (FPG), and 2-h postload plasma glucose in the Dutch general population and to evaluate the results of using A1C for screening and diagnosis of diabetes. RESEARCH DESIGN AND METHODS: In 2006–2007, 2,753 participants of the New Hoorn Study, aged 40–65 years, who were randomly selected from the population of Hoorn, the Netherlands, underwent an oral glucose tolerance test (OGTT). Glucose status (normal glucose metabolism [NGM], intermediate hyperglycemia, newly diagnosed diabetes, and known diabetes) was defined by the 2006 World Health Organization criteria. Spearman correlations were used to investigate the agreement between markers of hyperglycemia, and a receiver operating characteristic (ROC) curve was calculated to evaluate the use of A1C to identify newly diagnosed diabetes. RESULTS: In the total population, the correlations between fasting plasma glucose and A1C and between 2-h postload plasma glucose and A1C were 0.46 and 0.33, respectively. In patients with known diabetes, these correlations were 0.71 and 0.79. An A1C level of ≥5.8%, representing 12% of the population, had the highest combination of sensitivity (72%) and specificity (91%) for identifying newly diagnosed diabetes. This cutoff point would identify 72% of the patients with newly diagnosed diabetes and include 30% of the individuals with intermediate hyperglycemia. CONCLUSIONS: In patients with known diabetes, correlations between glucose and A1C are strong; however, moderate correlations were found in the general population. In addition, based on the diagnostic properties of A1C defined by ROC curve analysis, the advantage of A1C compared with OGTT for the diagnosis of diabetes is limited.

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  • The IEC A1C criteria have recently been compared with testing with fasting glucose or OGTTs in various populations to diagnose diabetes and high-risk/pre-diabetes.

    “The IEC A1C criteria have recently been compared with testing with fasting glucose or oral glucose tolerance tests (OGTTs) in various populations to diagnose diabetes (7–13) and high-risk/pre-diabetes (10,11,13), but the ADA A1C criteria have not been studied.”

    From Screening for Diabetes and Pre-Diabetes With Proposed A1C-Based Diagnostic Criteria (2010) · cites this paper as [10]

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Cited by

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Authors
van 't Riet, E., Alssema, M., Rijkelijkhuizen, J. M., Kostense, P. J., Nijpels, G., & Dekker, J. M.
Affiliations
  • EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands;
  • Amsterdam Public Health (NL)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2009-10-06
Volume
33
Issue
1
Pages
61-66
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc09-0677
PMC
PMC2797987
OpenAlex
W2037981927
Cited by
199
References
3
Citations by year
2026: 2 · 2025: 1 · 2024: 8 · 2023: 12 · 2022: 6 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 12 · 2017: 13 · 2016: 11 · 2015: 15 · 2014: 17 · 2013: 19 · 2012: 21
FWCI
15.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
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, fasting blood glucose, diabetes diagnosis, diabetes screening, oral glucose tolerance test, prediabetes, diagnostic accuracy, cut-off values, general population
MeSH terms
Adult, Aged, Blood Glucose, Diabetes Mellitus, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Male, Middle Aged, Netherlands, White People

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