Are there clinical implications of racial differences in HbA1c? A difference, to be a difference, must make a difference
Open accessAbstract
Studies that have compared HbA1c levels by race have consistently demonstrated higher HbA1c levels in African Americans than in whites. These racial differences in HbA1c have not been explained by measured differences in glycemia, sociodemographic factors, clinical factors, access to care, or quality of care. Recently, a number of nonglycemic factors and several genetic polymorphisms that operate through nonglycemic mechanisms have been associated with HbA1c Their distributions across racial groups and their impact on hemoglobin glycation need to be systematically explored. Thus, on the basis of evidence for racial differences in HbA1c, current clinical guidelines from the American Diabetes Association state: "It is important to take…race/ethnicity…into consideration when using the A1C to diagnose diabetes." However, it is not clear from the guidelines how this recommendation might be actualized. So, the critical question is not whether racial differences in HbA1c exist between African Americans and whites; the important question is whether the observed differences in HbA1c level are clinically meaningful. Therefore, given the current controversy, we provide a Point-Counterpoint debate on this issue. In the preceding point narrative, Dr. Herman provides his argument that the failure to acknowledge that HbA1c might be a biased measure of average glycemia and an unwillingness to rigorously investigate this hypothesis will slow scientific progress and has the potential to do great harm. In the counterpoint narrative below, Dr. Selvin argues that there is no compelling evidence for racial differences in the validity of HbA1c as a measure of hyperglycemia and that race is a poor surrogate for differences in underlying causes of disease risk.-William T. CefaluEditor in Chief, Diabetes Care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Other studies have demonstrated higher A1C levels in African American participants than in White participants at a given mean glucose concentration.
“Other studies have also demonstrated higher A1C levels in African American participants than in White participants at a given mean glucose concentration (15,16).”
From 6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [15]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Effects of Intensive Glucose Lowering in Type 2 Diabetes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0802743 · Cited by 7,888 · see citing works
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A. L., Tsapas, A., Wender, R., & Matthews, D. R. (2012) · Diabetologia · doi:10.1007/s00125-012-2534-0 · Cited by 3,919 · see citing works
Standards of medical care in diabetes 2010
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc10-s011 · Cited by 3,470 · see citing works
Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A. L., Tsapas, A., Wender, R., & Matthews, D. R. (2012) · Diabetes Care · doi:10.2337/dc12-0413 · Cited by 3,207 · see citing works
International Expert Committee report on the role of the A1c assay in the diagnosis of diabetes
The International Expert Committee (2009) · Diabetes Care · doi:10.2337/dc09-9033 · Cited by 3,185 · see citing works
Classification and Diagnosis of Diabetes
Fajans, S. S. (1990) · Medical Entomology and Zoology · Cited by 2,356 · see citing works
Selvin, E., & Erlinger, T. P. (2004) · Circulation · doi:10.1161/01.cir.0000137913.26087.f0 · Cited by 1,885 · cited 1× · see citing works
“Racial and ethnicminority groups are also disproportionately burdened by the complications of diabetes including retinopathy (9,10), chronic kidney disease (11), and lower-extremity peripheral vascular disease (12,13), with an especially high risk of amputation (14).”
BackgroundSelf-citationTranslating the A1C assay into estimated average glucose values
Nathan, D. M., Kuenen, J., Borg, R., Zheng, H., Schoenfeld, D., Heine, R. J., & for the A1c-Derived Average Glucose (ADAG) Study Group (2008) · Diabetes Care · doi:10.2337/dc08-0545 · Cited by 1,812 · see citing works
Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults
Selvin, E., Steffes, M. W., Zhu, H., Matsushita, K., Wagenknecht, L., Pankow, J., Coresh, J., & Brancati, F. L. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0908359 · Cited by 1,544 · see citing works
Self-citationHavranek, E. P., Mujahid, M. S., Barr, D. A., Blair, I. V., Cohen, M. S., Cruz-Flores, S., Davey-Smith, G., Dennison-Himmelfarb, C. R., Lauer, M. S., Lockwood, D. W., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000228 · Cited by 1,472 · see citing works
2. Classification and Diagnosis of Diabetes
American Diabetes Association (2015) · Diabetes Care · doi:10.2337/dc16-s005 · Cited by 1,087 · see citing works
Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis
Agardh, E. E., Allebeck, P., Hallqvist, J., Moradi, T., & Sidorchuk, A. (2011) · International Journal of Epidemiology · doi:10.1093/ije/dyr029 · Cited by 1,067 · see citing works
Gerstein, H. C., Miller, M., & Byington, R. P. (2010) · Cited by 981 · see citing works
Khaw, K.-T., Wareham, N., Bingham, S., Luben, R., Welch, A., & Day, N. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-6-200409210-00006 · Cited by 974 · see citing works
APOL1 Risk Variants, Race, and Progression of Chronic Kidney Disease
Parsa, A., Kao, W. H. L., Xie, D., Astor, B. C., Li, M., Hsu, C., Feldman, H. I., Parekh, R. S., Kusek, J. W., Greene, T., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1310345 · Cited by 786 · see citing works
The Clinical Information Value of the Glycosylated Hemoglobin Assay
Nathan, D. M., Singer, D. E., Hurxthal, K., & Goodson, J. D. (1984) · New England Journal of Medicine · doi:10.1056/nejm198402093100602 · Cited by 706 · see citing works
Racial and ethnic differences in glycemic control of adults with type 2 diabetes.
Harris, M. I., Eastman, R. C., Cowie, C. C., Flegal, K. M., & Eberhardt, M. S. (1999) · Diabetes Care · doi:10.2337/diacare.22.3.403 · Cited by 643 · see citing works
Gregg, E. W., Sorlie, P. D., Paulose‐Ram, R., Gu, Q., Eberhardt, M. S., WOLZ, M. M., Burt, V. L., Curtin, L. R., Engelgau, M. M., & Geiss, L. S. (2004) · Diabetes Care · doi:10.2337/diacare.27.7.1591 · Cited by 586 · 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
The biosynthesis of human hemoglobin A1c. Slow glycosylation of hemoglobin in vivo.
Bunn, H. F., Haney, D. N., Kamin, S., Gabbay, K. H., & Gallop, P. M. (1976) · Journal of Clinical Investigation · doi:10.1172/jci108436 · Cited by 565 · see citing works
Effects of hemoglobin variants and chemically modified derivatives on assays for glycohemoglobin
Bry, L., Chen, P. C., & Sacks, D. B. (2001) · Clinical Chemistry · doi:10.1093/clinchem/47.2.153 · Cited by 523 · see citing works
Incident Type 2 Diabetes Mellitus in African American and White Adults
Brancati, F. L., Kao, W. H. L., Folsom, A. R., Watson, R. L., & Szklo, M. (2000) · JAMA · doi:10.1001/jama.283.17.2253 · Cited by 502 · see citing works
McCane, D. R., Hanson, R. L., Charles, M. A., Jacobsson, L. T. H., Pettitt, D. D., Bennett, P. H., & Knowler, W. C. (1994) · BMJ · doi:10.1136/bmj.308.6940.1323 · Cited by 484 · see citing works
A1c versus glucose testing: a comparison
Sacks, D. B. (2011) · Diabetes Care · doi:10.2337/dc10-1546 · Cited by 461 · see citing works
Soranzo, N., Sanna, S., Wheeler, E., Gieger, C., Radke, D., Dupuis, J., Bouatia‐Naji, N., Langenberg, C., Prokopenko, I., Stolerman, E., et al. (2010) · Diabetes · doi:10.2337/db10-0502 · Cited by 445 · see citing works
Disparities in HbA1c Levels Between African-American and Non-Hispanic White Adults With Diabetes
Kirk, J. K., D’Agostino, R. B., Bell, R. A., Passmore, L. V., Bonds, D. E., Karter, A. J., & Narayan, K. M. V. (2006) · Diabetes Care · doi:10.2337/dc05-1973 · Cited by 332 · see citing works
Engelgau, M. M., Thompson, T. J., Herman, W. H., Boyle, J. P., Aubert, R. E., Kenny, S. J., Badran, A., Sous, E. S., & Ali, M. A. (1997) · Diabetes Care · doi:10.2337/diacare.20.5.785 · Cited by 325 · see citing works
Collins, F. S. (2004) · Nature Genetics · doi:10.1038/ng1436 · Cited by 314 · see citing works
Glycemic Thresholds for Diabetes-Specific Retinopathy
Colagiuri, S., Lee, C. M. Y., Wong, T. Y., Balkau, B., Shaw, J. E., Borch-Johnsen, K., & the DETECT-2 Collaboration Writing Group (2011) · Diabetes Care · doi:10.2337/dc10-1206 · Cited by 300 · see citing works
Tarver-Carr, M. E., Powe, N. R., Eberhardt, M. S., LaVeist, T. A., Kington, R. S., Coresh, J., & Brancati, F. L. (2002) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000026493.18542.6a · Cited by 284 · see citing works
Heianza, Y., Hara, S., Arase, Y., Saito, K., Fujiwara, K., Tsuji, H., Kodama, S., Hsieh, S. D., Mori, Y., Shimano, H., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60472-8 · Cited by 260 · see citing works
Wong, T. Y., Liew, G., Tapp, R. J., Schmidt, M. I., Wang, J. J., Mitchell, P. L. R., Klein, R., Klein, B. E. K., Zimmet, P., & Shaw, J. E. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60343-8 · Cited by 244 · see citing works
Hemoglobin AIc as an indicator of the degree of glucose intolerance in diabetes
Koenig, R. J., Peterson, C. M., Kilo, C., Cerami, A., & Williamson, J. R. (1976) · Diabetes · doi:10.2337/diab.25.3.230 · Cited by 236 · see citing works
Glycated hemoglobin measurement and prediction of cardiovascular disease
Di Angelantonio, E., Gao, P., Khan, H., Butterworth, A. S., Wormser, D., Kaptoge, S., Kondapally Seshasai, S. R., Thompson, A., Sarwar, N., Willeit, P., et al. (2014) · JAMA · doi:10.1001/jama.2014.1873 · Cited by 231 · cited 1× · see citing works
“Indeed, studies using modern HbA1c assays have now shown that HbA1c is more strongly associated with outcomes as compared with fasting glucose or 2-h postprandial glucose (19,54).”
BackgroundSelf-citationInzucchi, S. E. (2012) · New England Journal of Medicine · doi:10.1056/nejmcp1103643 · Cited by 212 · see citing works
Racial differences in glycemic markers: a cross-sectional analysis of community-based data
Selvin, E., Steffes, M. W., Ballantyne, C. M., Hoogeveen, R. C., Coresh, J., & Brancati, F. L. (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-154-5-201103010-00004 · Cited by 196 · see citing works
Self-citationHbA1c and Peripheral Arterial Disease in Diabetes
Selvin, E., Wattanakit, K., Steffes, M. W., Coresh, J., & Sharrett, A. R. (2006) · Diabetes Care · doi:10.2337/diacare.29.04.06.dc05-2018 · Cited by 184 · see citing works
Self-citationMatsushita, K., Blecker, S., Pazin-Filho, A., Bertoni, A., Chang, P. P., Coresh, J., & Selvin, E. (2010) · Diabetes · doi:10.2337/db10-0165 · Cited by 183 · see citing works
Self-citationDistribution of HbA1c Levels For Children and Young Adults in the U.S.
Saaddine, J. B., Fagot-Campagna, A., Rolka, D., Narayan, K. M. V., Geiss, L., Eberhardt, M., & Flegal, K. M. (2002) · Diabetes Care · doi:10.2337/diacare.25.8.1326 · Cited by 177 · see citing works
Use of HbA1c in Predicting Progression to Diabetes in French Men and Women
Droumaguet, C., Balkau, B., Simon, D., Caces, E., Tichet, J., Charles, M. A., Eschwege, E., & the DESIR Study Group (2006) · Diabetes Care · doi:10.2337/dc05-2525 · Cited by 159 · see citing works
Cheng, Y. J., Gregg, E. W., Geiss, L. S., Imperatore, G., Williams, D. E., Zhang, X., Albright, A. L., Cowie, C. C., Klein, R., & Saaddine, J. B. (2009) · Diabetes Care · doi:10.2337/dc09-0440 · Cited by 157 · see citing works
The measurement and importance of red cell survival
Franco, R. S. (2008) · American Journal of Hematology · doi:10.1002/ajh.21298 · Cited by 153 · see citing works
Selvin, E., Coresh, J., Shahar, E., Zhang, L., Steffes, M. W., & Sharrett, A. R. (2005) · The Lancet Neurology · doi:10.1016/s1474-4422(05)70227-1 · Cited by 146 · see citing works
Self-citationSelvin, E., Yang, N., Steffes, M. W., Bash, L. D., Klein, R., Wong, T. Y., Astor, B. C., Sharrett, A. R., Brancati, F. L., & Coresh, J. (2010) · Diabetes · doi:10.2337/db10-1198 · Cited by 135 · see citing works
Self-citationPitfalls in the use of HbA1c as a diagnostic test: the ethnic conundrum
Dagogo-Jack, S. (2010) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2010.126 · Cited by 131 · see citing works
Basic Performance of an Enzymatic Method for Glycated Albumin and Reference Range Determination
Kohzuma, T., Yamamoto, T., Uematsu, Y., Shihabi, Z. K., & Freedman, B. I. (2011) · Journal of Diabetes Science and Technology · doi:10.1177/193229681100500619 · Cited by 122 · see citing works
1. Strategies for Improving Care
American Diabetes Association (2015) · Diabetes Care · doi:10.2337/dc16-s004 · Cited by 108 · see citing works
Shafi, T., Sozio, S. M., Plantinga, L., Jaar, B. G., Kim, E. T., Parekh, R. S., Steffes, M. W., Powe, N. R., Coresh, J., & Selvin, E. (2012) · Diabetes Care · doi:10.2337/dc12-1896 · Cited by 103 · see citing works
Self-citationMortensen, H. B., & Christophersen, C. (1983) · Clinica Chimica Acta · doi:10.1016/0009-8981(83)90370-4 · Cited by 79 · see citing works
Diagnostic thresholds for diabetes: The association of retinopathy and albuminuria with glycaemia
Tapp, R. J., Zimmet, P., Harper, C. A., de Courten, M., McCarty, D. J., Balkau, B., Taylor, H. R., Welborn, T. A., & Shaw, J. E. (2006) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2006.02.008 · Cited by 73 · see citing works
Should the Hemoglobin A 1c Diagnostic Cutoff Differ Between Blacks and Whites?
Tsugawa, Y., Mukamal, K. J., Davis, R. B., Taylor, W. C., & Wee, C. C. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-3-201208070-00004 · Cited by 72 · see citing works
Socioeconomic Factors and Racial Disparities in Kidney Disease Outcomes
Crews, D. C., Pfaff, T., & Powe, N. R. (2013) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2013.07.008 · Cited by 69 · see citing works
GHb Level and Subsequent Mortality Among Adults in the U.S.
Saydah, S., Tao, M., Imperatore, G., & Gregg, E. W. (2009) · Diabetes Care · doi:10.2337/dc09-0117 · Cited by 67 · see citing works
Jørgensen, M. E., Bjerregaard, P., Borch‐Johnsen, K., & Witte, D. R. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0710 · Cited by 55 · see citing works
Hemoglobin A1c in Diabetes: Panacea or Pointless?
Sacks, D. B. (2012) · Diabetes · doi:10.2337/db12-1485 · Cited by 54 · see citing works
Menke, A., Rust, K., Savage, P. J., & Cowie, C. C. (2013) · Annals of Epidemiology · doi:10.1016/j.annepidem.2013.10.008 · Cited by 53 · see citing works
Selvin, E., Rawlings, A. M., Bergenstal, R. M., Coresh, J., & Brancati, F. L. (2013) · Diabetes Care · doi:10.2337/dc12-2715 · Cited by 51 · see citing works
No Ethnic Differences in the Association of Glycated Hemoglobin With Retinopathy
Bower, J. K., Brancati, F. L., & Selvin, E. (2012) · Diabetes Care · doi:10.2337/dc12-0404 · Cited by 49 · see citing works
Self-citationSabanayagam, C., Khoo, E. Y. H., Lye, W. K., Ikram, M. K., Lamoureux, E. L., Cheng, C., Tan, M. L. S., Salim, A., Lee, J., Lim, S.-C., et al. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-2498 · Cited by 48 · see citing works
Soranzo, N. (2011) · Current Diabetes Reports · doi:10.1007/s11892-011-0232-9 · Cited by 45 · see citing works
Does Genetic Ancestry Explain Higher Values of Glycated Hemoglobin in African Americans?
Maruthur, N. M., Kao, W. H. L., Clark, J. M., Brancati, F. L., Cheng, C., Pankow, J. S., & Selvin, E. (2011) · Diabetes · doi:10.2337/db11-0319 · Cited by 43 · see citing works
Self-citationJack, L., Jack, N. H., & Hayes, S. C. (2012) · Diabetes Spectrum · doi:10.2337/diaspect.25.1.9 · Cited by 40 · see citing works
New Diabetes Diagnostic Threshold of Hemoglobin A1c and the 3-Year Incidence of Retinopathy
Tsugawa, Y., Takahashi, O., Meigs, J. B., Davis, R. B., Imamura, F., Fukui, T., Taylor, W. C., & Wee, C. C. (2012) · Diabetes · doi:10.2337/db12-0103 · Cited by 40 · see citing works
Prevalence and Risk Factors of Retinopathy in an Asian Population Without Diabetes
Jeganathan, V. S. E. (2010) · Archives of Ophthalmology · doi:10.1001/archophthalmol.2009.330 · Cited by 33 · see citing works
Zhong, X., Yuan, M., Li, H., Hua, L., Feng, J., Shi, J. C., Zhu, X.-R., Cao, X., & Yang, J. (2012) · PLoS ONE · doi:10.1371/journal.pone.0040610 · Cited by 32 · see citing works
Racial differences in and prognostic value of biomarkers of hyperglycemia
Parrinello, C. M., Sharrett, A. R., Maruthur, N. M., Bergenstal, R. M., Grams, M. E., Coresh, J., & Selvin, E. (2016) · Diabetes Care · doi:10.2337/dc15-1360 · Cited by 29 · see citing works
Self-citationAn, P., Miljkovic, I., Thyagarajan, B., Kraja, A. T., Daw, E. W., Pankow, J. S., Selvin, E., Kao, W. H. L., Maruthur, N. M., Nalls, M. A., et al. (2013) · Metabolism · doi:10.1016/j.metabol.2013.11.018 · Cited by 28 · see citing works
Self-citationEthnic/racial determinants of glycemic markers in a UK sample
Shipman, K. E., Jawad, M., Sullivan, K. M., Ford, C., & Gama, R. M. (2015) · Acta Diabetologica · doi:10.1007/s00592-014-0703-y · Cited by 23 · see citing works
Diagnosing Diabetes With Glucose Criteria: Worshipping a False God
Davidson, M. B. (2011) · Diabetes Care · doi:10.2337/dc10-1689 · Cited by 23 · see citing works
Park, Y., Ko, S., Lee, J.-M., Kim, D. J., Kim, D. J., Han, K., Bower, J. K., & Ahn, Y. (2014) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2014.04.003 · Cited by 22 · see citing works
Prevalence of retinopathy and its risk factors in a J apanese population
Fukushima, S., Nakagami, T., Suto, C., et al. (2013) · Journal of Diabetes Investigation · doi:10.1111/jdi.12044 · Cited by 14 · see citing works
de Miranda, V. A., Filho, R. A. D. C., de Oliveira, T. S., Moscavitch, S. D., Kang, H. C., Chagas, S. V. D. M., Costa, D. M., Araújo, D. V., & Rosa, M. L. G. (2013) · Primary care diabetes · doi:10.1016/j.pcd.2013.01.007 · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2022</i>
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s002 · Cited by 4,792 · see citing works
2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2020</i>
American Diabetes Association (2020) · Diabetes Care · doi:10.2337/dc20-s002 · Cited by 3,187 · see citing works
2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2021</i>
American Diabetes Association (2021) · Diabetes Care · doi:10.2337/dc21-s002 · Cited by 3,116 · see citing works
2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2018</i>
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dc18-s002 · Cited by 3,159 · see citing works
2. Diagnosis and Classification of Diabetes: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Gaglia, J. L., Hilliard, M. E., Johnson, E. L., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s002 · Cited by 2,086 · see citing works
Self-citation6. Glycemic Targets: <i>Standards of Medical Care in Diabetes—2022</i>
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s006 · Cited by 1,403 · see citing works
2. Diagnosis and classification of diabetes: standards of care in diabetes-2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Ebekozien, O., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s002 · Cited by 1,393 · see citing works
Self-citation6. Glycemic Targets: <i>Standards of Medical Care in Diabetes—2021</i>
American Diabetes Association (2021) · Diabetes Care · doi:10.2337/dc21-s006 · Cited by 847 · see citing works
6. Glycemic Targets: <i>Standards of Medical Care in Diabetes—2020</i>
American Diabetes Association (2020) · Diabetes Care · doi:10.2337/dc20-s006 · Cited by 744 · see citing works
6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i>
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s006 · Cited by 684 · see citing works
6. Glycemic Targets: <i>Standards of Medical Care in Diabetes—2019</i>
American Diabetes Association (2019) · Diabetes Care · doi:10.2337/dc19-s006 · Cited by 655 · see citing works
Babulal, G. M., Quiroz, Y. T., Albensi, B. C., Arenaza‐Urquijo, E., Astell, A. J., Babiloni, C., Bahar‐Fuchs, A., Bell, J., Bowman, G. L., Brickman, A. M., et al. (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2018.09.009 · Cited by 528 · see citing works
Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.08.002 · Cited by 507 · see citing works
Bergenstal, R. M., Gal, R. L., Connor, C. G., Gubitosi-Klug, R., Kruger, D., Olson, B. A., Willi, S. M., Aleppo, G., Weinstock, R. S., Wood, J., et al. (2017) · Annals of Internal Medicine · doi:10.7326/m16-2596 · Cited by 306 · see citing works
Metrics for glycaemic control - from HbA1c to continuous glucose monitoring
Kovatchev, B. P. (2017) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.3 · Cited by 272 · see citing works
Cavagnolli, G., Pimentel, A. L., Freitas, P. A. C., Gross, J. L., & Camargo, J. L. (2017) · PLOS ONE · doi:10.1371/journal.pone.0171315 · Cited by 138 · see citing works
Fabris, C., Heinemann, L., Beck, R., Cobelli, C., & Kovatchev, B. (2020) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2020.0236 · Cited by 58 · see citing works
Mañé, L., Flores-Le Roux, J. A., Gómez, N., Chillarón, J. J., Llauradó, G., Gortazar, L., Payà, A., Pedro-Botet, J., & Benaiges, D. (2019) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2019.03.017 · Cited by 39 · see citing works
HbA1c for type 2 diabetes diagnosis in Africans and African Americans: personalized medicine now
Paterson, A. D. (2017) · PLOS Medicine · doi:10.1371/journal.pmed.1002384 · Cited by 26 · see citing works
- Authors
- Selvin, E.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Selvin, Elizabeth
- ORCID
- Selvin, Elizabeth
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2016-07-12
- Volume
- 39
- Issue
- 8
- Pages
- 1462-1467
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC4955930
- OpenAlex
- W2481518965
- Cited by
- 96
- References
- 73
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 19 · 2020: 13 · 2019: 12 · 2018: 10 · 2017: 7 · 2016: 4
- FWCI
- 11.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (2R01DK089174, K24DK106414)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Race, Genetics, and Society
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- HbA1c, racial differences, African Americans, diabetes diagnosis, glycemic control, hemoglobin glycation, genetic polymorphism, clinical significance, American Diabetes Association guidelines
- MeSH terms
- Aged, Black or African American, Blood Glucose, Decision Making, Diabetes Mellitus, Glycated Hemoglobin, Humans, Hyperglycemia, Cholesterol, HDL, Cholesterol, LDL, Middle Aged, Prognosis, Risk Factors, Socioeconomic Factors, Triglycerides, Reproducibility of Results, White People, Atherosclerosis, Renal Insufficiency, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
