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What A1c Is Diagnostic Of Diabetes?

The Pros And Cons Of Diagnosing Diabetes With A1c

The Pros And Cons Of Diagnosing Diabetes With A1c

An International Expert Committee was convened in 2008 by the American Diabetes Association (ADA), the European Association for the Study of Diabetes, and the International Diabetes Federation to consider the means for diagnosing diabetes in nonpregnant individuals, with particular focus on the possibility to indicate A1C as an alternative if not a better tool (1). After reviewing the available literature and a thorough discussion on the advantages and the limits of previous diagnostic strategies (essentially based on fasting glucose assessment) and the considered alternative approach (based on A1C measurement), a consensus was reached that the latter (i.e., A1C) should be included among diagnostic tools for diabetes and, with the exception of a number of clinical conditions, should even be preferred in diabetes diagnosis in nonpregnant adults. The main conclusion of the International Expert Committee was implemented in the most recent clinical recommendations issued by the ADA. However, in these guidelines, A1C is indicated as a diagnostic tool alternative but not superior to blood glucose, leaving to the health care professional the decision about what test to use in an individual. The World Health Organization is currently examining the proposal made by the International Expert Committee and is carefully addressing the controversial issues still remaining, most of which have been the subject of letters to the editor and articles recently published in the literature. Nevertheless, the use of A1C for diagnosing diabetes is rapidly becoming a reality in many Western countries. In the text that follows, one of us (E.B.) will present the main points supporting A1C (pros) and the other (J.T.) will illustrate the main counterpoints challenging A1C (cons) as the primary tool Continue reading >>

All About The Hemoglobin A1c Test

All About The Hemoglobin A1c Test

People with diabetes used to depend only on urine tests or daily finger sticks to measure their blood sugars. These tests are accurate, but only in the moment. As an overall measurement of blood sugar control, they’re very limited. This is because blood sugar can vary wildly depending on the time of day, activity levels, and even hormone changes. Some people may have high blood sugars at 3 a.m. and be totally unaware of it. Once A1C tests became available in the 1980s, they became an important tool in controlling diabetes. A1C tests measure average blood glucose over the past two to three months. So even if you have a high fasting blood sugar, your overall blood sugars may be normal, or vice versa. A normal fasting blood sugar may not eliminate the possibility of type 2 diabetes. This is why A1C tests are now being used for diagnosis and screening of prediabetes. Because it doesn’t require fasting, the test can be given as part of an overall blood screening. The A1C test is also known as the hemoglobin A1C test or HbA1C test. Other alternate names include the glycosylated hemoglobin test, glycohemoglobin test, and glycated hemoglobin test. A1C measures the amount of hemoglobin in the blood that has glucose attached to it. Hemoglobin is a protein found inside red blood cells that carries oxygen to the body. Hemoglobin cells are constantly dying and regenerating, but they have a lifespan of approximately three months. Glucose attaches, or glycates, to hemoglobin, so the record of how much glucose is attached to your hemoglobin also lasts for about three months. If there’s too much glucose attached to the hemoglobin cells, you’ll have a high A1C. If the amount of glucose is normal, your A1C will be normal. The test is effective because of the lifespan of the hemogl Continue reading >>

Hemoglobin A1c For The Diagnosis Of Diabetes: Practical Considerations

Hemoglobin A1c For The Diagnosis Of Diabetes: Practical Considerations

Abstract The International Expert Committee recommends that the diagnosis of diabetes be made if hemoglobin A1c (HbA1c) level is ≥6.5% and confirmed with a repeat HbA1c test. The committee recommends against "mixing different methods to diagnose diabetes" because "the tests are not completely concordant: using different tests could easily lead to confusion". Fasting plasma glucose, 2-hour postglucose-load plasma glucose, and oral glucose tolerance tests are recommended for the diagnosis of diabetes only if HbA1c testing is not possible due to unavailability of the assay, patient factors that preclude its interpretation, and during pregnancy. HbA1c testing has the advantages of greater clinical convenience, preanalytic stability, and assay standardization, but when used as the sole diagnostic criterion for diabetes, it has the potential for systematic error. Factors that may not be clinically evident impact HbA10 test results and may systematically raise or lower the value relative to the true level of glycemia. For this reason, HbA1c should be used in combination with plasma glucose determinations for the diagnosis of diabetes. If an HbA1c test result is discordant with the clinical picture or equivocal, plasma glucose testing should be performed. A diagnostic cut-off point of HbA1c ≥6.5% misses a substantial number of people with type 2 diabetes, including some with fasting hyperglycemia, and misses most people with impaired glucose tolerance. Combining the use of HbA1c and plasma glucose measurements for the diagnosis of diabetes offers the benefits of each test and reduces the risk of systematic bias inherent in HbA1c testing alone. Copyright by Medycyna Praktyczna, 2010. Continue reading >>

Diagnosis Of Type 2 Diabetes Mellitus

Diagnosis Of Type 2 Diabetes Mellitus

There is a continuum of risk for poor patient outcomes as glucose tolerance progresses from normal to overt type 2 diabetes. AACE-defined glucose tolerance categories are listed in Table 1.1 Table 1. Glucose Testing and Interpretation1 Normal High Risk for Diabetes Diabetes FPG < 100 mg/dL IFG FPG ≥100-125 mg/dL FPG ≥126 mg/dL 2-hour PG <140 mg/dL (measured with an OGTT performed 2 hours after 75 g oral glucose load taken after 8-hour fast) IGT 2-hour PG ≥140-199 mg/dL 2-hour PG ≥200 mg/dL Random PG ≥200 mg/dL plus symptoms of diabetes (polyurea, polydipsia, or polyphagia) A1C < 5.5% 5.5% to 6.4% For screening of prediabetesa ≥6.5% Secondaryb Abbreviations: A1C = hemoglobin A1C; FPG = fasting plasma glucose; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; PG = plasma glucose. a A1C should be used only for screening prediabetes. The diagnosis of prediabetes, which may manifest as either IFG or IGT, should be confirmed with glucose testing. b Glucose criteria are preferred for the diagnosis of DM. In all cases, the diagnosis should be confirmed on a separate day by repeating glucose or A1C testing. When A1C is used for diagnosis, follow-up glucose testing should be done when possible to help manage diabetes. The diagnostic cut points recommended by the American Diabetes Association (ADA) differ slightly from the AACE recommendations; please see the ADA Standards of Medical Care in Diabetes for details.2 In addition to glucose criteria, type 1 diabetes (T1D) is diagnosed according to the presence of autoantibodies to glutamic acid decarboxylase, pancreatic islet (beta) cells, or insulin.1,2 Type 2 diabetes (T2D) accounts for 90% of diabetes cases and is usually identified in individuals 30 years or older who are overweight or obese and/or have Continue reading >>

Type 2 Diabetes Symptoms And Diagnosis

Type 2 Diabetes Symptoms And Diagnosis

Because type 2 diabetes develops slowly, and symptoms generally come on gradually, they may go unnoticed for a long time, or they may be attributed to something else. For example, increased thirst may be chalked up to a hot summer, or fatigue may be interpreted as a sign of aging or stress. This is unfortunate, because even short-term high blood sugar (hyperglycemia) diminishes your quality of life. And if high blood sugar persists for a long time, it can eventually cause complications such as diabetic retinopathy or kidney disease (diabetic nephropathy) that cannot be completely reversed with improved blood sugar control. Type 2 diabetes can cause a wide range of signs and symptoms, including: Fatigue Dry mouth Thirst Excessive urination Hunger Weight loss Blurry vision Cloudy thinking Irritability Wounds that won't heal Infections associated with undiagnosed type 2 diabetes include gum infections, urinary tract infections (particularly in women), slowly healing wounds with subsequent infections, and infections of the feet. Symptoms in Men Type 2 diabetes symptoms are generally the same for men and women. However, urological problems such as erectile dysfunction (ED) — the inability to achieve or maintain an erection — have been associated with all forms of diabetes, including type 2. According to the National Diabetes Information Clearinghouse, 20 to 75 percent of men with any type of diabetes have ED. Researchers believe diabetes causes sexual function problems in men due to damage to the body's autonomic nervous system, which controls circulation. If you have the symptoms of ED, it may be a sign you have diabetes. Another urological problem associated with diabetes in men is retrograde ejaculation, or the release of semen into the bladder during ejaculation. Sym Continue reading >>

Clinical Presentation And Diagnosis Of Diabetes Mellitus In Adults

Clinical Presentation And Diagnosis Of Diabetes Mellitus In Adults

INTRODUCTION The term diabetes mellitus describes several diseases of abnormal carbohydrate metabolism that are characterized by hyperglycemia. It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin. Every few years, the diabetes community reevaluates the current recommendations for the classification, diagnosis, and screening of diabetes, reflecting new information from research and clinical practice. The American Diabetes Association (ADA) issued diagnostic criteria for diabetes mellitus in 1997, with follow-up in 2003 and 2010 [1-3]. The diagnosis is based on one of four abnormalities: glycated hemoglobin (A1C), fasting plasma glucose (FPG), random elevated glucose with symptoms, or abnormal oral glucose tolerance test (OGTT) (table 1). Patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are referred to as having increased risk for diabetes or prediabetes. (See 'Diagnostic criteria' below.) Screening for and prevention of diabetes is reviewed elsewhere. The etiologic classification of diabetes mellitus is also discussed separately. (See "Screening for type 2 diabetes mellitus" and "Prevention of type 2 diabetes mellitus" and "Prevention of type 1 diabetes mellitus" and "Classification of diabetes mellitus and genetic diabetic syndromes".) CLINICAL PRESENTATION Type 2 diabetes is by far the most common type of diabetes in adults (>90 percent) and is characterized by hyperglycemia and variable degrees of insulin deficiency and resistance. The majority of patients are asymptomatic, and hyperglycemia is noted on routine laboratory evaluation, prompting further testing. The frequency of symptomatic diabetes has been decreasing in parallel wi Continue reading >>

Diagnosis Of Diabetes

Diagnosis Of Diabetes

Diabetes is a condition of elevated blood sugar where the body does not produce enough insulin or the body is unable to respond properly to the insulin that is produced. Insulin is a hormone that is made in the pancreas, which is a small organ situated behind the stomach. Insulin is important because it moves glucose, a simple sugar, from the blood into the body's cells. It also has a number of other important effects on metabolism. The foods people eat provide the body with glucose, which is used by the cells as a source of energy. If insulin isn't available or doesn't work correctly to move glucose from the blood into the cells, glucose will stay in the blood. High blood glucose levels are toxic. Cells that don't get glucose are lacking the fuel they need to work properly. The symptoms of diabetes are a result of high sugar levels in the blood. Diabetes is diagnosed by taking a blood glucose level. When screening for diabetes, the physician or primary health care provider might take what is called a "random" blood sugar level. This is a sugar level that is taken at any time of the day, without any specific preparation and independent of the food that has been eaten. A random blood sugar level of at least 11.1 mmol/L can be used to diagnose diabetes. Other diagnostic tests can include the measurement of a fasting blood sugar level. A fasting blood sugar of at least 7.0 mmol/L can be used to diagnose diabetes. Also, a 75 g oral glucose tolerance test (OGTT) can be used to diagnose diabetes. A 2-hour blood sugar level of at least 11.1 mmol/L after an OGTT can be used to diagnose diabetes. Lastly, an A1C (which measures the average blood sugar levels over the past 2 to 3 months) of at least 6.5% can be used to diagnose diabetes. A1C is not used to diagnose diabetes for ch Continue reading >>

Glycohemoglobin (hba1c, A1c)

Glycohemoglobin (hba1c, A1c)

A A A Test Overview Glycohemoglobin (A1c) is a blood test that checks the amount of sugar (glucose) bound to the hemoglobin in the red blood cells. When hemoglobin and glucose bond, a coat of sugar forms on the hemoglobin. That coat gets thicker when there's more sugar in the blood. A1c tests measure how thick that coat has been over the past 3 months, which is how long a red blood cell lives. People who have diabetes or other conditions that increase their blood glucose levels have more glycohemoglobin than normal. An A1c test can be used to diagnose prediabetes or diabetes. The A1c test checks the long-term control of blood glucose levels in people with diabetes. Most doctors think checking an A1c level is the best way to check how well a person is controlling his or her diabetes. A home blood glucose test measures the level of blood glucose only at that moment. Blood glucose levels change during the day for many reasons, including medicine, diet, exercise, and the level of insulin in the blood. It is useful for a person who has diabetes to have information about the long-term control of blood sugar levels. The A1c test result does not change with any recent changes in diet, exercise, or medicines. Glucose binds to hemoglobin in red blood cells at a steady rate. Since red blood cells last 3 to 4 months, the A1c test shows how much glucose is in the plasma part of blood. This test shows how well your diabetes has been controlled in the last 2 to 3 months and whether your diabetes treatment plan needs to be changed. The A1c test can also help your doctor see how big your risk is of developing problems from diabetes, such as kidney failure, vision problems, and leg or foot numbness. Keeping your A1c level in your target range can lower your chance for problems. Why It Is Continue reading >>

Glycolated Hemoglobin Test (a1c)

Glycolated Hemoglobin Test (a1c)

The glycosylated hemoglobin test (A1c, also called hemoglobin A1c or the glycosylated hemoglobin test) is an important blood test to diagnose diabetes or determine control of your diabetes. It provides an average blood glucose measurement over the past 3 months and is used in conjunction with home glucose monitoring to make treatment adjustments. The normal range for the A1c test is less than 5.7% for people without diabetes, 5.7%-6.4% for those with pre-diabetes. For people with diabetes, it is 6.5% or higher. For diagnostic purposes, two separate A1c tests at 6.5% are positive for diabetes. People with diabetes who are treated with insulin should have this test 4 times a year (every 3 months). The test may be needed more frequently when your diabetes is not well-controlled. However, the test should be performed no more often than every 6 weeks. Those who are not treated with insulin should have this test every 4 to 6 months. If your A1c is 12.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 298. If your A1c is 11.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 269. If your A1c is 10.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 240. If your A1c is 9.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 212. If your A1c is 8.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 183. If your A1c is 7.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 154. If your A1c is 6.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 126. If your A1c is 5.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 97. Continue reading >>

Symptoms, Diagnosis & Monitoring Of Diabetes

Symptoms, Diagnosis & Monitoring Of Diabetes

According to the latest American Heart Association's Heart Disease and Stroke Statistics, about 8 million people 18 years and older in the United States have type 2 diabetes and do not know it. Often type 1 diabetes remains undiagnosed until symptoms become severe and hospitalization is required. Left untreated, diabetes can cause a number of health complications. That's why it's so important to both know what warning signs to look for and to see a health care provider regularly for routine wellness screenings. Symptoms In incidences of prediabetes, there are no symptoms. People may not be aware that they have type 1 or type 2 diabetes because they have no symptoms or because the symptoms are so mild that they go unnoticed for quite some time. However, some individuals do experience warning signs, so it's important to be familiar with them. Prediabetes Type 1 Diabetes Type 2 Diabetes No symptoms Increased or extreme thirst Increased thirst Increased appetite Increased appetite Increased fatigue Fatigue Increased or frequent urination Increased urination, especially at night Unusual weight loss Weight loss Blurred vision Blurred vision Fruity odor or breath Sores that do not heal In some cases, no symptoms In some cases, no symptoms If you have any of these symptoms, see your health care provider right away. Diabetes can only be diagnosed by your healthcare provider. Who should be tested for prediabetes and diabetes? The U.S. Department of Health and Human Services recommends that you should be tested if you are: If your blood glucose levels are in normal range, testing should be done about every three years. If you have prediabetes, you should be checked for diabetes every one to two years after diagnosis. Tests for Diagnosing Prediabetes and Diabetes There are three ty Continue reading >>

Have Diabetes? It Depends On What Country You're In

Have Diabetes? It Depends On What Country You're In

Open this photo in gallery: "So, Dr. Q, do I have it or not?" asked Michael, a 47-year-old man who had just returned from Michigan. His wife, my patient, had brought him in to see me to clarify his diagnosis. He had undergone blood tests in Detroit and was told by his doctor there that he had diabetes. Upset and disbelieving, he refused to take medications. Once in Canada, he went to see his own family doctor. After doing blood tests here, his Canadian physician told him he was fine - and that he did not have diabetes. "Well, yes and no," I had to reply. It was an unusual situation based on different diabetes-testing criteria in the United States and Canada. The same patient with the same results can be told that he either has or does not have the condition. "Michael, both your doctors are right. In Michigan, you have diabetes. In Toronto, you don't." That didn't seem to help his peace of mind. Doctors are supposed to be without borders, and the diagnosis of common conditions should not change between countries that share so much. But American physicians are diagnosing diabetes even more aggressively than their Canadian counterparts. In January, 2010, the American Diabetes Association essentially made it easier for patients to be diagnosed with diabetes by adding the important Hemoglobin A1C test to the diagnostic list. Now, in the United States, a HbA1C level greater than 6.5 per cent means you have diabetes. Previously, the U.S. gold standard test for diabetes was an overnight fasting sugar (glucose) level of 7.0 millimoles per litre of blood or higher. That still holds for Canada. In fact, Canadian doctors are not even supposed to do the HbA1C test until a person has been fully diagnosed with diabetes by the usual fasting glucose tests. The HbA1C test is used only to Continue reading >>

Prediabetes Symptoms And Diagnosis

Prediabetes Symptoms And Diagnosis

What is prediabetes? About 41 million Americans between the ages of 40 and 74 have "prediabetes." Prediabetes is a condition that can be considered an early, yet potentially reversible stage of the development of type 2 diabetes. Prediabetes is sometimes called impaired glucose tolerance or impaired fasting glucose (IGT/IFG), depending upon the test that yielded the abnormal result. In prediabetes, a person's blood sugar (glucose) levels are slightly higher than the normal range, but not high enough for a true diagnosis of diabetes. People with prediabetes have a significant risk of developing full-blown diabetes. In the Diabetes Prevention Program study, about 11% of people with prediabetes developed type II diabetes each year during the three year follow-up time of the study. Importantly, people with prediabetes generally have no symptoms of the condition. Testing for Pre Diabetes Doctors generally use one of two different blood tests to diagnose diabetes and prediabetes. One is called the fasting plasma glucose test (FPG) in which a person's blood glucose level is measured first thing in the morning before breakfast. The normal fasting blood glucose level is below 100 mg/dl. A person with prediabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the fasting blood glucose level is to 126 mg/dl or above, a person is considered to have diabetes. The second test used in the diagnosis of diabetes is the oral glucose tolerance test (OGTT), although this test is no longer commonly used as in the past. This test may be used to diagnose gestational diabetes in pregnant women. In this test, a person's blood glucose is measured in the morning after fasting overnight and again two hours after drinking a glucose-rich beverage. The normal value for blood glucose Continue reading >>

Diagnosis

Diagnosis

It's important for diabetes to be diagnosed early so treatment can be started as soon as possible. If you experience the symptoms of diabetes, visit your GP as soon as possible. They'll ask about your symptoms and may request blood and urine tests. Your urine sample will be tested for glucose. Urine doesn't normally contain glucose, but glucose can overflow through the kidneys and into your urine if you have diabetes. If your urine contains glucose, a specialised blood test known as glycated haemoglobin (HbA1c) can be used to determine whether you have diabetes. Glycated haemoglobin (HbA1c) In people who have been diagnosed with diabetes, the glycated haemoglobin (HbA1c) test is often used to show how well their diabetes is being controlled. The HbA1c test gives your average blood glucose levels over the previous two to three months. The results can indicate whether the measures you're taking to control your diabetes are working. If you've been diagnosed with diabetes, it's recommended you have your HbA1c measured at least twice a year. However, you may need to have your HbA1c measured more frequently if: you've recently been diagnosed with diabetes your blood glucose remains too high your treatment plan has been changed Unlike other tests, such as the glucose tolerance test (GTT), the HbA1c test can be carried out at any time of day and doesn't require any special preparation, such as fasting. However, the test can't be used in certain situations, such as during pregnancy. The advantages associated with the HbA1c test make it the preferred method of assessing how well blood glucose levels are being controlled in a person with diabetes. HbA1c can also be used as a diagnostic test for diabetes and as a screening test for people at high risk of diabetes. HbA1c as a diagno Continue reading >>

Diabetes Mellitus Type 2

Diabetes Mellitus Type 2

Discussion Diagnostic Criteria In 1997, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus published a new classification scheme and revised diagnostic criteria for diabetes mellitus (the following criteria are from the 2013 revision). Classification of Diabetes Mellitus Diagnostic elements: genetic markers; autoantibodies, clinical characteristics (ketosis, pattern of progression, obesity, age and treatment response) Type 1: β-cell destruction usually leading to absolute insulin deficiency Type 2: Insulin resistance with insulin secretion deficiency. 90 - 95% of people who have diabetes have Type 2. Other specific types: Genetic defects in β-cell function Genetic defects in insulin action Exocrine pancreas diseases Endocrinopathies Drug- or chemical-induced Infections Other rare forms Gestational Diagnosis of Diabetes Mellitus (Any finding falling within a positive criteria should be repeated on a subsequent day with another test in any criteria set: e.g., a random plasma glucose with symptoms, might be followed-up with a fasting plasma glucose.) Fasting plasma glucose (FPG) ≥ 126 mg/dl (7.0 mmol/l) OR Symptoms (such as polyuria, polydipsia, unexplained weight loss) AND a random plasma glucose ≥ 200 mg/dl (11.1 mmol/l) OR Plasma glucose ≥ 200 mg/dl ( 11.1 mmol/l) 2 hours after a 75g glucose load OR A1C ≥ 6.5%. Categories of increased risk for diabetes (prediabetes): Fasting plasma glucose (FPG) levels: 100 to 125mg/dl (5.6 - 6.9mmol/l) [IFG]; OR 2-h PG values in the 75-g oral glucose tolerance test (OGIT)): 140 mg/dl to 199 mg/dl (7.8 - 11.0 mmol/l) [IGT]; OR A1C: 5.7 - 6.4%. Gestational Diabetes Mellitus (GDM) Screen at 24-28 weeks 75g OGTT: fasting: ≥ 92mg/dl (5.1 mmol/l) ; OR 1 hr: ≥ 180mg/dl (10.0 mmol/l); OR 2 hr: ≥ 153mg Continue reading >>

Hemoglobin A1c For The Diagnosis Of Diabetes: To Replace Or To Guide Oral Glucose Tolerance Tests?

Hemoglobin A1c For The Diagnosis Of Diabetes: To Replace Or To Guide Oral Glucose Tolerance Tests?

Abstract Aims/Introduction: To evaluate if hemoglobin A1c (A1C) can replace the use of the oral glucose tolerance test (OGTT) to diagnose diabetes in Chinese patients. Materials and Methods: Subjects without pre-existing diabetes were included in this community-based study. Each participant received a 75-g OGTT and A1C tests. Results: A total of 1362 subjects, 512 men and 850 women, aged 18–88 years, were enrolled. The prevalence of diabetes was 7.4 and 7.3% by OGTT and by A1C ≥ 6.5% criteria, respectively. The optimal A1C cut-off for diabetes defined by OGTT was 6.1%. The performance of A1C ≥ 6.1% to find diabetes by OGTT was poor, with a kappa 0.50, sensitivity 80% and specificity 91%. Using current criteria of fasting plasma glucose (FPG) < 5.56 mmol/L to exclude and ≥7 mmol/L to diagnose diabetes (FPG criterion), the sensitivity, specificity and OGTT required were 77.2, 100 and 13.5%, respectively. Using A1C < 5.9% to exclude and ≥7.0% to diagnose diabetes (A1C criterion), the sensitivity, specificity and OGTT required were 89.1, 99.8 and 26.5%, respectively. However, using FPG < 5.56 mmol/L and A1C < 6.1% to exclude, and A1C ≥ 7.0% to diagnose diabetes (A1C plus FPG criterion), the sensitivity, specificity and OGTT required were 85.2, 100 and 18.9%, respectively. Conclusions: To screen for diabetes, the A1C criterion is more sensitive than the FPG criterion, with more OGTT needed. The A1C plus FPG criterion reduced the number of OGTT needed with acceptable sensitivity. A1C can guide, but cannot replace, OGTT to diagnose diabetes. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00181.x, 2011) Introduction In January 2010, the use of A1C to diagnose DM was officially recommended by the ADA1,2. A1C has been shown to correlate with the occurrence of diabe Continue reading >>

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