Moving to an A1C-based diagnosis of diabetes has a different impact on prevalence in different ethnic groups

TY - JOUR

T1 - Moving to an A1C-based diagnosis of diabetes has a different impact on prevalence in different ethnic groups

AU - Christensen, Dirk L

AU - Witte, Daniel R

AU - Kaduka, Lydia

AU - Jørgensen, Marit E

AU - Borch-Johnsen, Knut

AU - Mohan, Viswanathan

AU - Shaw, Jonathan E

AU - Tabák, Adam G

AU - Vistisen, Dorte

N1 - Keywords: Adult; Aged; Australia; Confounding Factors (Epidemiology); Denmark; Diabetes Mellitus; Diagnostic Techniques, Endocrine; Ethnic Groups; Female; Great Britain; Greenland; Hemoglobin A, Glycosylated; Humans; India; Kenya; Male; Middle Aged; Prevalence

PY - 2010/3

Y1 - 2010/3

N2 - OBJECTIVE - To compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria. RESEARCH DESIGN AND METHODS - Six studies (1999-2009) from Denmark, the U.K., Australia, Greenland, Kenya, and India were tested for the probability of an A1C ≥6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. RESULTS - Diabetes prevalence was lower with the A1C-based diagnostic criteria in four of six studies. The probability of an A1C ≥6.5% among OGTT-diagnosed case subjects ranged widely (17.0-78.0%) by study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. study were of the same magnitude as between-country comparisons. CONCLUSIONS - A shift to an A1C-based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations.

AB - OBJECTIVE - To compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria. RESEARCH DESIGN AND METHODS - Six studies (1999-2009) from Denmark, the U.K., Australia, Greenland, Kenya, and India were tested for the probability of an A1C ≥6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. RESULTS - Diabetes prevalence was lower with the A1C-based diagnostic criteria in four of six studies. The probability of an A1C ≥6.5% among OGTT-diagnosed case subjects ranged widely (17.0-78.0%) by study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. study were of the same magnitude as between-country comparisons. CONCLUSIONS - A shift to an A1C-based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations.

KW - Faculty of Health and Medical Sciences

U2 - 10.2337/dc09-1843

DO - 10.2337/dc09-1843

M3 - Journal article

C2 - 20009099

SN - 0149-5992

VL - 33

SP - 580

EP - 582

JO - Diabetes Care

JF - Diabetes Care

IS - 3

ER -