Is HbA1c a good diagnostic test for (pre)diabetes in cardiac rehabilitation patients?

Smulders, Yvo M.; Serné, Erik H.

doi:10.1177/2047487318757553

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…However, it has been debated how valuable this is in clinical practice. 6,7 HbA1c does not diagnose all people with T2DM, and the only way to identify impaired glucose tolerance (IGT) is via an OGTT. 8 Combinations of different measurements define several forms of pre-diabetes.…”

Section: Definition Of Pre-diabetesmentioning

confidence: 99%

Risk and management of pre-diabetes

Beulens

Rutters

Rydén

et al. 2019

Eur J Prev Cardiolog

130

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Type 2 diabetes mellitus (T2DM) is associated with a two- to four-fold increased risk of developing cardiovascular disease (CVD) and microvascular complications, which may already be present before diagnosis. It is, therefore, important to detect people with an increased risk of T2DM at an early stage. In order to identify individuals with so-called ‘pre-diabetes’, comprising impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), current guidelines have developed definitions based on fasting plasma glucose, two-hour glucose concentrations and haemoglobin A1c. Subjects with pre-diabetes are at an increased risk of developing T2DM and CVD. This elevated risk seems similar according to the different criteria used to define pre-diabetes. The risk of progression to T2DM or CVD does, however, depend on other risk factors such as sex, body mass index and ethnicity. Based on the risk factors to develop T2DM, many risk assessment models have been developed to identify those at highest risk. These models perform well to identify those at risk and could be used to initiate preventive interventions. Many studies have shown that lifestyle modification and metformin are effective in preventing the development of T2DM, although lifestyle modification seems to have a more sustainable effect. In addition, lifestyle modification seems more effective in those with IGT than those with IFG. In this review, we will describe the different definitions used to define pre-diabetes, progression from pre-diabetes to T2DM or other vascular complications, risk factors associated with progressions and the management of progression to T2DM, ending with clinical recommendations.

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Section: Definition Of Pre-diabetesmentioning

confidence: 99%

Risk and management of pre-diabetes

Beulens

Rutters

Rydén

et al. 2019

Eur J Prev Cardiolog

130

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“…HbA 1c is the gold standard for long-term monitoring of glycemic control, correlation with occurrence of long term micro and macrovascular complications and treatment target by most clinicians. 26,27,28 Accordingly, in our study, HbA 1c was assayed as glycemic control index among diabetic patients where statistically significant higher frequency of homozygous GG genotype and G allele among patients with HbA 1c ≥ 8 % was found compared to patients with HbA 1c < 8% (p = 0.001 and 0.018, respectively); assuming an association between SDF-1β G801A gene polymorphism and poor glycemic control. Our assumption can find its explanation based on researchers who reported that SDF-1β G801A gene polymorphism has been found to up regulate the expression of SDF-1, 3 8, 10, 29 and accordingly SDF-1 binds to the specific receptor CXCR4 participating in various immune and inflammation reactions.…”

Section: Discussionmentioning

confidence: 74%

Evaluation of stromal cell-derived factor-1β Gene polymorphism G801A among Egyptian patients with type 2 diabetes mellitus

Farhan

Abougabal

Ellatif

et al. 2021

EJI

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Stromal cell derived factor – 1 (SDF-1) is expressed by bone marrow derived stromal cells and stromal tissues in multiple organs. SDF-1 possesses diverse physiological and biochemical functions concerning autoimmunity and inﬂammation. SDF-1 gene polymorphisms play various roles in immune related diseases. This study aimed to evaluate association of SDF-1β G801A gene polymorphism and type 2 diabetes mellitus (T2DM) as regard prevalence and glycemic control. The study included hundred Egyptian subjects; 50 patients with T2DM recruited from the Internal Medicine Department, Beni-Suef University Hospital, and 50 age and sex matched healthy subjects. Participants were subjected to full clinical examination and routine laboratory investigations including fasting blood glucose, 2 hours post prandial blood glucose, serum creatinine, lipid profile and glycated hemoglobin (HbA1c). SDF-1β G801A gene polymorphism was analyzed using polymerase chain reaction -restriction fragment length polymorphism (PCR-RFLP). The frequency of GG and AG genotypes was higher in patients compared to controls with no statistical significance. Higher frequency of homozygous GG genotype and G allele were observed among patients with poor glycemic control (HbA1c ≥ 8% ) compared to those with good glycemic control (HbA1c < 8%) (P = 0.001 and 0.018 respectively). In conclusion, this study suggested an association between SDF-1 β gene polymorphism and type 2 diabetes mellitus in Egyptian patients. Further studies are needed to confirm our observations.

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“…Thus, HbA1c only contributed a small proportion above that disclosed by FPG plus 2hPG. 26 These and other data, 26,27 although not undisputed, 28 favour the use of OGTT, if the ambition is to disclose as many dysglycaemic patients as possible in high-risk populations with established CAD for appropriate risk stratification and treatment with glucose-lowering agents that also reduce mortality and cardiovascular disease (Figure 2). 29 This approach contrasts with the regular diagnostic algorithm in the general population, which involves using risk score questionnaires for screening and the use of HbA1c measurements for diagnosis.…”

Section: Diabetes Prevalence Of the Adult Populationmentioning

confidence: 99%

The global epidemics of diabetes in the 21st century: Current situation and perspectives

Standl

Khunti

Hansen

et al. 2019

Eur J Prev Cardiolog

314

161

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Diabetes is on the rise worldwide, with a global prevalence in adults in 2017 being 8.8% of the world population, with the anticipation of a further increase to 9.9% by 2045. In total numbers, this reflects a population of 424.9 million people with diabetes worldwide in 2017, with an estimate of a 48% increase to 628.6 million people by 2045. Depending on age, global diabetes prevalence is about 5%, 10%, 15% and close to 20%, respectively, for the age groups 35–39, 45–49, 55–59 and 65–69 years. On a global scale, diabetes hits particularly ‘middle aged’ people between 40 and 59 years, which causes serious economic and social implications. Furthermore, diabetes affects especially low and middle income countries, as 77% of all people with diabetes worldwide live in those countries. In addition to overt diabetes, an estimated 352.1 million people worldwide are at risk of diabetes, i.e. have defined pre-diabetes, a figure which is anticipated to rise to 531.6 million by 2045. Some 70–75% of all patients with established coronary artery disease, e.g. with acute myocardial infarction, show concomitant diabetes or abnormal glucose regulation, i.e. close to 50% have overt diabetes, with as many as 20% of those being undiagnosed and another 25% having pre-diabetes.

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Is HbA1c a good diagnostic test for (pre)diabetes in cardiac rehabilitation patients?

Cited by 5 publications

References 9 publications

Risk and management of pre-diabetes

Risk and management of pre-diabetes

Evaluation of stromal cell-derived factor-1β Gene polymorphism G801A among Egyptian patients with type 2 diabetes mellitus

The global epidemics of diabetes in the 21st century: Current situation and perspectives

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