Comparison of glycosylated hemoglobin and fasting plasma glucose with two-hour post-load plasma glucose in the detection of diabetes mellitus.
In the course of a screening for diabetes mellitus in the Hôtel-Dieu Hospital in Paris, from September 15, 1981 to April 1, 1984, an oral glucose tolerance test and a measurement of glycosylated hemoglobin were performed on 333 outpatients. With two-hour plasma glucose as a reference, the sensitivities of glycosylated hemoglobin, fasting plasma glucose, and a combination of glycosylated hemoglobin and fasting plasma glucose equal, respectively, 60.0%, 52.0%, and 40.0%; the specificities 90.9%, 98.7%, and 99.4%; the predictive value for a positive diagnosis 34.9%, 76.5%, and 83.3%. If one takes into account the implications of diabetes mellitus, especially its economic and psychosociologic consequences, it seems better for diagnosis--from a public health point of view--to use tests with a high degree of specificity and a high predictive value for a positive diagnosis, such as the combination of fasting plasma glucose and glycosylated hemoglobin, than tests with a good sensitivity but poor specificity. In the long term, validation of glycosylated hemoglobin as a diagnostic test for asymptomatic diabetes mellitus will be obtained only by reference to unquestionable criteria of the disease, determined by longitudinal survey.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure; D002853:Chromatography, Liquid; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005069:Evaluation Studies as Topic; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D006442:Glycated Hemoglobin