Combined Measurement of Fasting Plasma Glucose and A1C Is Effective for the Prediction of Type 2 Diabetes

Abstract

OBJECTIVE -We prospectively assessed whether the combined measurements of fasting plasma glucose (FPG) and A1C were effective for predicting type 2 diabetes.RESEARCH DESIGN AND METHODS -Study participants included 6,736 nondiabetic Japanese men aged 40 -55 years. Type 2 diabetes was diagnosed in those who had an FPG Ն126 mg/dl or who were being treated with an oral antidiabetic agent or insulin. The models including FPG, A1C, and both were compared using the area under the receiver operating characteristic (AUROC) curves.RESULTS -During the 4-year follow-up period, we confirmed 659 diabetes cases. In multivariate analysis, both FPG and A1C were independently associated with the risk of type 2 diabetes. The model including both FPG and A1C had a greater AUROC curve than that including FPG alone (0.853 vs. 0.818; P Ͻ 0.001) or A1C alone (0.853 vs. 0.771; P Ͻ 0.001).CONCLUSIONS -The combined measurement of FPG and A1C was effective for predicting type 2 diabetes. Diabetes Care 32:644-646, 2009

A Risk Score for Predicting the Incidence of Type 2 Diabetes in a Middle-Aged Korean Cohort

“…The model with HbA1c did not provide additional capability to discriminate individuals who developed diabetes from those who did not, although the HbA1c in the clinical model was significantly associated with the incidence of diabetes (P<0.0001). This result differed from the results of Sato et al, 28 who showed that a model including both FPG and HbA1c had a greater AROC than those that included FPG alone. The AROC or cstatistic measure is the most popular method of assessing discriminatory ability, and their interpretation is simple and direct.…”

“…27 Recently, Sato et al suggested that the combined measurement of FPG and HbA1c was effective for predicting diabetes. 28 They found that both FPG and HbA1c are independently associated with the risk of diabetes. A French cohort study reported the use of HbA1c in identifying subjects with impaired fasting glucose.…”

HbA1c, fasting plasma glucose and the prediction of diabetes: Inter99, AusDiab and D.E.S.I.R.

“…The oral glucose tolerance test is rarely used in clinical practice and we define diabetes in this article by either FPG ≥ 7.0 mmol/l and/or HbA1c ≥ 6.5%, as this combination is likely to be used in clinical practice, as proposed in other publications [15,16]. However, we have also included diabetes defined additionally by 2hPG ≥ 11.1 mmol/l, to evaluate possible changes in FPG and HbA1c thresholds.…”

Type 2 Diabetes Prevention: Implications of Hemoglobin A1c Genetics

“…Indeed, individuals with moderately elevated HbA1c levels have higher incident rates of T2D over time [49][50][51][52][53][54][55][56][57][58][59][60], supporting the use of HbA1c for risk stratification in the general population. HbA1c is also able to predict future T2D in various nonEuropean populations around the world [9,10,51,[53][54][55][56][57][58][59]61]. In the 1990s, the Diabetes Control and Complications Trial (DCCT) [62] and United Kingdom Prospective Diabetes Study (UKPDS) [63] established clear relationships between HbA1c levels and risk of diabetes-related endpoints in both type 1 diabetes and T2D patients.…”