Performance of an A1C and Fasting Capillary Blood Glucose Test for Screening Newly Diagnosed Diabetes and Pre-Diabetes Defined by an Oral Glucose Tolerance Test in Qingdao, China
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OBJECTIVE The study's goal was to evaluate the performance of A1C and fasting capillary blood glucose (FCG) tests as mass screening tools for diabetes and pre-diabetes, as determined by the standard oral glucose tolerance test (OGTT). RESEARCH DESIGN AND METHODS Data from 2,332 individuals aged 35-74 years who participated in a population-based cross-sectional diabetes survey in Qingdao, China, were analyzed. A 2-h 75-g OGTT was used to diagnose diabetes. The performance of A1C and FCG was evaluated against the results of the OGTTs by using receiver operating characteristic curve (ROC) analysis. RESULTS The prevalence of newly diagnosed diabetes and pre-diabetes (impaired fasting glucose and/or impaired glucose tolerance) was 11.9 and 29.5%, respectively. For subjects with newly diagnosed diabetes, the area under the ROC curve was 0.67 for A1C and 0.77 for FCG (P < 0.01) in men and 0.67 and 0.75 (P < 0.01) in women, whereas for pre-diabetes, these values were 0.47 and 0.64 (P < 0.001) in men and 0.51 and 0.65 (P < 0.001) in women. At the optimal A1C cutoff point of > or =5.6% for newly diagnosed diabetes, sensitivities (specificities) were 64.4% (61.6%) for men and 62.3% (63.3%) for women. CONCLUSIONS As a screening tool for newly diagnosed diabetes and pre-diabetes, the FCG measurement performed better than A1C in this general Chinese population.
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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 [13]
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- Authors
- Zhou, X., Pang, Z., Gao, W., Wang, S., Zhang, L., Ning, F., & Qiao, Q.
- Affiliations
- University of Helsinki (FI)
- Qingdao Municipal Center for Disease Control and Prevention (CN)
- Corresponding author
- Pang, Zengchang
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-12-10
- Volume
- 33
- Issue
- 3
- Pages
- 545-550
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2827505
- OpenAlex
- W2097958244
- Cited by
- 146
- References
- 26
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 12 · 2019: 8 · 2018: 7 · 2017: 11 · 2016: 7 · 2015: 13 · 2014: 15 · 2013: 19 · 2012: 9
- FWCI
- 7.28
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- Bayer HealthCare
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- HbA1c, diabetes screening, prediabetes, oral glucose tolerance test, impaired fasting glucose, impaired glucose tolerance, diagnostic accuracy, newly diagnosed diabetes, Chinese population
- MeSH terms
- Adult, Aged, Blood Glucose, Capillaries, China, Cross-Sectional Studies, Diabetes Mellitus, Diagnostic Techniques, Endocrine, Efficiency, Fasting, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Male, Mass Screening, Middle Aged, Prediabetic State, Early Diagnosis
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