scholarly journals Fasting Plasma Glucose and the HbA1c Are Not Optimal Screening Modalities for the Diagnosis of New Diabetes in Previously Undiagnosed Asian Indian Community Participants

2018 ◽  
Vol 28 (1) ◽  
pp. 19 ◽  
Author(s):  
Rosaley Prakaschandra ◽  
Datshanna Prakesh Naidoo
Keyword(s):  
High Risk ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Predictive Accuracy ◽  
Positive Family History ◽  
Tolerance Test ◽  
Undiagnosed Diabetes ◽  
Oral Glucose ◽  
Fasting Plasma ◽  
Optimal Screening

<p class="Pa7"><strong>Objectives: </strong>There is no definitive consensus on the screening algorithm in high-risk com­munities for diabetes. The aims of our study were to determine the prevalence of undi­agnosed diabetes in a high-risk community using the oral glucose tolerance test (OGTT), as well as determine the value of anthropo­metric measurements and other measures of glycemia in the detection of diabetes.</p><p class="Pa7"><strong>Method: </strong>All participants from the Phoenix Lifestyle project without known diabetes, and who had undergone an OGTT were selected for study. Anthropometric measure­ments were collected according to accepted guidelines. Diabetes was diagnosed if fasting plasma glucose (FPG) ≥7.0 mmol/l, if 2-hour plasma glucose level during OGTT was ≥ 11.0 mmol/l, or if HbA1c ≥ 6.5%.</p><p class="Pa7"><strong>Results: </strong>The prevalence of newly diagnosed diabetes was 14.3% (11.7 % age standard­ized) (women=15.4%; men=11.8%). The prevalence rates were underestimated using FPG criteria, but overestimated when using the HbA1c. The AUC (area under the receiver-operator characteristics curve) was highest for FPG (.879), HbA1c (.855), then anthropometry measures (BMI=.621; waist circumference=.627). For diabetes, at levels <span style="text-decoration: underline;">&gt;</span>6.3, the discriminant ability (DA) of HbA1c was highest (79%), while a cut-point of ≥5.5mmol/l for FPG yielded a DA= 81.5% (82% sensitivity; 81%; specificity of 81%). There was a low level of agreement between the FPG (Kappa = .506), HbA1c (Kappa = .537), and the OGTT. Age- and sex-adjusted independent determinants of diabetes using stepwise backward logistic regression were age, triglyceride levels and a positive family history for diabetes.</p><p class="Default"><strong>Conclusion: </strong>Neither the HbA1c nor the FPG approached adequate predictive accuracy in the diagnosis of diabetes. In view of the high prevalence of undiagnosed diabetes, this study underscores the need for ongoing national surveillance data.</p><p class="Default"><em>Ethn Dis. </em>2018;28(1):19-24; doi:10.18865/ed.28.1.19.</p>

scholarly journals Comparison of Diagnostic Criteria to Detect Undiagnosed Diabetes in Acute Coronary Syndrome Patients with Admission Hyperglycemia

2015 ◽  
Vol 8 (1) ◽  
pp. 35-42
Author(s):  
Mohammad Sarwar Alam ◽  
HI Lutfur Rahman Khan ◽  
Abdul Wadud Chowdhury ◽  
Khandker Md Nurus Sabah ◽  
Md Gaffar Amin ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Oral Glucose Tolerance Test ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Tolerance Test ◽  
Undiagnosed Diabetes ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Coronary Syndrome ◽  
Fasting Plasma

Background: Diabetes mellitus is one of the most important risk factors of coronary artery disease. Admission hyperglycemia adversely influences the outcome of acute coronary syndrome patients. The study was conducted to compare the various diagnostic methods for the detection of undiagnosed diabetes mellitus in acute coronary syndrome patients with admission hyperglycaemia in Bangladeshi population.Methods: It was a cross sectional comparative study involving 157 patients with admission blood glucose level e”7.8 mmol/l. Fasting plasma glucose, Glycated haemoglobin, pre-discharge oral glucose tolerance test was measured in all subjects and comparison of performance of different methods was done.Results: Oral glucose tolerance test revealed that in spite of admission hyperglycaemia, 57 (36.3%) patients were diabetic and 52 (33.12%) patients had impaired glucose homeostasis and 48 (30.57%) patients had normal glucose metabolism. Undiagnosed diabetes could not be adequately predicted with admission plasma glucose, fasting plasma glucose or HbA1c alone (area under the ROC curve 0.589, 0.825 and 0.852 respectively).Conclusion: Admission hyperglycaemia does not diagnose diabetes reliably in a stressful condition like acute coronary syndrome. Although neither admission plasma glucose, fasting plasma glucose, nor HbA1c level were as good as oral glucose tolerance test in detecting true diabetes, but combined fasting plasma glucose & HbA1c were found to be more sensitive & specific screening tool for detecting unknown diabetes in acute coronary syndrome patients with admission hyperglycaemia.Cardiovasc. j. 2015; 8(1): 35-42

scholarly journals The role of serum fasting plasma glucose in gestational diabetes screening

2020 ◽  
Vol 28 (1) ◽  
pp. 11-16
Author(s):  
İlknur Çöl Madendağ ◽  
Mefkure Eraslan Şahin ◽  
Yusuf Madendağ
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Threshold Value ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Fasting Plasma ◽  
Specificity And Sensitivity ◽  
Tertiary Center

Objective We aimed to investigate the performance of fasting plasma glucose (FPG) level, checked between 24 and 28 weeks of gestation, for the diagnosis of gestational diabetes mellitus (GDM) in order to find out whether FPG level would help to identify potential GDM cases or not in pregnancies which do or do not undergo oral glucose tolerance test (OGTT). Methods This study was performed retrospectively in a tertiary center by accessing the records of 2950 patients who underwent 75-g OGTT in between 24 and 28 weeks of gestation. GDM diagnosis was established according to the one-step screening test results. In the patients diagnosed with GDM, the most successful threshold value for the diagnosis calculated statistically was determined for FPG. The specificity and sensitivity values were calculated for FPG. Results After applying the exclusion criteria, 1736 of 2043 pregnant women were normal and 307 (15%) of them were diagnosed with GDM. The mean age was higher in the pregnant women with GDM than the healthy pregnant women when they were compared according to the demographic characteristics (28.6±4.3 vs. 26.2±4.1, p<0.001). Body mass index was also higher in the pregnant women with GDM compared to the health pregnant women (26±2.1 vs. 24±3.1 kg/m2, p<0.001). Other characteristics were similar in both groups. ROC analysis was performed for FPG and the most significant threshold value was found 88 mg/dL (p<0.001, area under curve 0.876, 95% confidence interval 0.850–0.903). Conclusion When FPG is >88 mg/dl in pregnant women who do not want to undergo OGTT, they should be informed in detail about both OGTT and GDM and its potential complications. Thus, the number of GDM cases without diagnosis and its potential complications would decrease.

scholarly journals Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Wichai Aekplakorn ◽  
Valla Tantayotai ◽  
Sakawduan Numsangkul ◽  
Wilarwan Sripho ◽  
Nutchanat Tatsato ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Diabetes Prevention Program ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Kappa Statistics ◽  
Family History Of Diabetes ◽  
Fasting Plasma

Aim. To evaluate an agreement in identifying dysglycemia between fasting plasma glucose (FPG) and the 2 hr postprandial glucose tolerance test (OGTT) in a population with high risk of diabetes.Methods. A total of 6,884 individuals aged 35–65 years recruited for a community-based diabetes prevention program were tested for prediabetes including impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and diabetes. The agreement was assessed by Kappa statistics. Logistic regression was used to examine factors associated with missed prediabetes and diabetes by FPG.Results. A total of 2671 (38.8%) individuals with prediabetes were identified. The prevalence of prediabetes identified by FPG and OGTT was 32.2% and 22.3%, respectively. The proportions of diabetes classified by OGTT were two times higher than those identified by FPG (11.0% versus 5.4%, resp.). The Kappa statistics for agreement of both tests was 0.55. Overall, FPG missed 46.3% of all prediabetes and 54.7% of all diabetes cases. Prediabetes was more likely to be missed by FPG among female, people aged <45 yrs, and those without family history of diabetes.Conclusion. The detection of prediabetes and diabetes using FPG only may miss half of the cases. Benefit of adding OGTT to FPG in some specific groups should be confirmed.

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