Fasting plasma glucose diagnostic criterion, proposed by the American Diabetes Association, has low sensitivity for diagnoses of diabetes in Mexican population.
To determine the best cutoff value of fasting plasma glucose (FPG) for diagnosis of diabetes, using the 2-h postglucose load (2-h PG) as the gold standard, in Mexican population and compare it to the 7.0 mmol/l limit proposed by the American Diabetes Association (ADA). 712 apparently healthy Mexican individuals were included in a cross-sectional randomized population survey. Sensitivity of FPG criterion for diagnoses of type 2 diabetes was calculated from a fourfold table. Glycemia value 2-h PG of >or=11.1 mmol/l was the "gold standard" diagnostic test. The optimal FPG value for diagnoses of diabetes was established on a receiver operating characteristic (ROC) scatter plot. On the basis of the "gold standard" diagnostic test, diagnosis of type 2 diabetes was established in 65 (9.12%) subjects, whereas the ADA FPG diagnostic criterion only identified 39 (5.47%) subjects; that is a sensitivity of 60% (CI(95%) 47.1-72.0). The ROC scatter plot showed the best cutoff value of FPG for diagnoses of diabetes that corresponds to 6.1 mmol/l, which has the highest sensitivity (0.985). FPG diagnostic criterion proposed by the ADA Expert Committee for diagnosis of type 2 diabetes has low sensitivity in Mexican population. For epidemiological purposes, estimates of diabetes prevalence in Mexico based on a FPG value of >or=6.1 mmol/l will improve the success of the screening.
Rodríguez-Morán
M
M
Medical Research Unit in Clinical Epidemiology of the Instituto Mexicano del Seguro Social, Durango, Mexico. rodriguez_moran@hotmail.com
Guerrero-Romero
F
F
D000328:Adult; D001774:Blood Chemical Analysis / Q000592:standards; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism*; D001827:Body Height; D001835:Body Weight; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014481:United States; D014837:Voluntary Health Agencies
D001786:Blood Glucose