Comparison of A1C and Fasting Glucose Criteria to Diagnose Diabetes Among U.S. Adults
Open accessAbstract
OBJECTIVE: To compare A1C and fasting glucose for the diagnosis of diabetes among U.S. adults. RESEARCH DESIGN AND METHODS: This study included 6,890 adults (≥20 years of age) from the 1999–2006 National Health and Nutrition Examination Survey without a self-reported history of diabetes who had fasted ≥9 h. A1C ≥6.5% and fasting glucose ≥126 mg/dl were used, separately, to define diabetes. RESULTS: Overall, 1.8% of U.S. adults had A1C ≥6.5% and fasting glucose ≥126 mg/dl, 0.5% had A1C ≥6.5% and fasting glucose <126 mg/dl, and 1.8% had A1C <6.5% and fasting glucose ≥126 mg/dl. Compared with individuals with A1C <6.5% and fasting glucose ≥126 mg/dl, individuals with A1C ≥6.5% and fasting glucose <126 mg/dl were younger, more likely to be non-Hispanic black, had lower Hb levels, and had higher C-reactive protein. CONCLUSIONS: A1C ≥6.5% demonstrates reasonable agreement with fasting glucose for diagnosing diabetes among U.S. adults.
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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 [7]
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Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (2003) · Diabetes Care · doi:10.2337/diacare.26.2007.s5 · Cited by 2,689 · see citing works
Herman, W. H., Ma, Y., Uwaifo, G., Haffner, S., Kahn, S. E., Horton, E. S., Lachin, J. M., Montez, M. G., Brenneman, T., Barrett-Connor, E., et al. (2007) · Diabetes Care · doi:10.2337/dc06-2003 · Cited by 574 · see citing works
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Srikanthan, P., Hevener, A. L., & Karlamangla, A. S. (2010) · PLoS ONE · doi:10.1371/journal.pone.0010805 · Cited by 600 · see citing works
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Screening for Diabetes and Pre-Diabetes With Proposed A1C-Based Diagnostic Criteria
Olson, D. E., Rhee, M. K., Herrick, K., Ziemer, D. C., Twombly, J. G., & Phillips, L. S. (2010) · Diabetes Care · doi:10.2337/dc10-0433 · Cited by 234 · see citing works
“None of the studies found the IEC high-risk criteria to be similar to pre-diabetes with OGTTs (10,11,13).”
InfluentialGuo, F., Moellering, D. R., & Garvey, W. T. (2014) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2013.0128 · Cited by 139 · see citing works
Karnchanasorn, R., Huang, J., Ou, H.-Y., Feng, W., Chuang, L.-M., Chiu, K. C., & Samoa, R. (2016) · Journal of Diabetes Research · doi:10.1155/2016/6195494 · Cited by 59 · see citing works
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Diagnosing Dysglycemia in Adolescents With Polycystic Ovary Syndrome
Gooding, H. C., Milliren, C., St. Paul, M., Mansfield, M. J., & DiVasta, A. (2014) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.12.020 · Cited by 17 · see citing works
- Authors
- Carson, A. P., Reynolds, K., Fonseca, V. A., & Muntner, P.
- Affiliations
- University of Alabama at Birmingham (US)
- Kaiser Permanente (US)
- Texas A&M Health Science Center (US)
- Corresponding author
- Carson, April P.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-10-06
- Volume
- 33
- Issue
- 1
- Pages
- 95-97
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2797994
- OpenAlex
- W2109864539
- Cited by
- 183
- References
- 2
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 9 · 2023: 7 · 2022: 6 · 2021: 6 · 2020: 4 · 2019: 5 · 2018: 9 · 2017: 11 · 2016: 7 · 2015: 20 · 2014: 17 · 2013: 15 · 2012: 17
- FWCI
- 15.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- 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
- diabetes diagnosis, HbA1c, fasting blood glucose, diagnostic criteria, diagnostic agreement, NHANES, C-reactive protein, hemoglobin levels, non-Hispanic Black adults
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Sensitivity and Specificity, United States
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