Comparing risk profiles of individuals diagnosed with diabetes by OGTT and HbA1c The Danish Inter99 study

TY - JOUR

T1 - Comparing risk profiles of individuals diagnosed with diabetes by OGTT and HbA1c The Danish Inter99 study

AU - Borg, R

AU - Vistisen, D

AU - Witte, D R

AU - Borch-Johnsen, K

PY - 2010/8

Y1 - 2010/8

N2 - Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the World Health Organization classification or by the newly proposed HbA1c level ≥ 6.5% among 6258 participants of the Danish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA 1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7-4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0-7.2%) had diabetes by HbA1c levels. HbA1c-defined individuals were relatively older with higher proportions of men, smokers, lipid abnormalities and macro-albuminuria, but they were leaner and had lower blood pressure. HbA1c was better than fasting- and 2-h plasma glucose at distinguishing between individuals of high and low predicted risk of ischaemic heart disease; however, the difference between HbA1c and fasting- and 2-h plasma glucose was not statistically significant. Conclusions Compared with the current oral glucose tolerance test definition, more individuals were classified as having diabetes based on the HbA1c criteria. This group had as unfavourable a risk profile as those identified by the oral glucose tolerance test.

AB - Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the World Health Organization classification or by the newly proposed HbA1c level ≥ 6.5% among 6258 participants of the Danish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA 1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7-4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0-7.2%) had diabetes by HbA1c levels. HbA1c-defined individuals were relatively older with higher proportions of men, smokers, lipid abnormalities and macro-albuminuria, but they were leaner and had lower blood pressure. HbA1c was better than fasting- and 2-h plasma glucose at distinguishing between individuals of high and low predicted risk of ischaemic heart disease; however, the difference between HbA1c and fasting- and 2-h plasma glucose was not statistically significant. Conclusions Compared with the current oral glucose tolerance test definition, more individuals were classified as having diabetes based on the HbA1c criteria. This group had as unfavourable a risk profile as those identified by the oral glucose tolerance test.

KW - Blood Glucose/metabolism

KW - Denmark/epidemiology

KW - Diabetes Mellitus, Type 2/diagnosis

KW - Diabetic Angiopathies/diagnosis

KW - Fasting

KW - Female

KW - Glucose Tolerance Test/methods

KW - Glycated Hemoglobin A/metabolism

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Ischemia/diagnosis

KW - Prevalence

KW - Risk Assessment

U2 - 10.1111/j.1464-5491.2010.03034.x

DO - 10.1111/j.1464-5491.2010.03034.x

M3 - Journal article

C2 - 20653748

SN - 1464-5491

VL - 27

SP - 906

EP - 910

JO - Diabetic Medicine Online

JF - Diabetic Medicine Online

IS - 8

ER -