title: Fasting plasma glucose diagnostic criterion, proposed by the American Diabetes Association, has low sensitivity for diagnoses of diabetes in Mexican population.
abstract: 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.
authors.affiliation: Medical Research Unit in Clinical Epidemiology of the Instituto Mexicano del Seguro Social, Durango, Mexico. rodriguez_moran@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Morán
authors.forename: F
authors.initials: F
authors.lastname: Guerrero-Romero
mesh_terms: 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
chemical_list: D001786:Blood Glucose