Performance characteristics of the new definition of diabetes: the insulin resistance atherosclerosis study.
OBJECTIVE
A1C > or =6.5% has been recently proposed as the defining criterion for diabetes. However, performance characteristics of this definition have not been described.


METHODS
In the Insulin Resistance Atherosclerosis Study, we compared new to previous definitions of diabetes: 1999 World Health Organization (DM(1999WHO)) and 2003 American Diabetes Association based on fasting glucose alone (DM(FPG126)).


RESULTS
Participants with A1C > or =6.5%, DM(1999WHO), and DM(FPG126) were 44 (5.2%), 132 (15.4%), and 61 (7.1%), respectively. In individuals with DM(1999WHO), mean, median, and interquartile range of A1C were 6.3, 5.9, and 5.5-6.6%, respectively; in individuals with DM(FPG126), mean, median, and interquartile range of A1C were 7.0, 6.6, and 6.0-7.1%.


CONCLUSIONS
A1C > or =6.5% identifies fewer individuals than DM(1999WHO) or DM(FPG126). Studies are needed to determine that A1C > or =6.5% compromises neither blood pressure and lipid management in early diabetes nor the implementation of lifestyle interventions for diabetes prevention.
Lorenzo
Carlos
C
Department of Medicine, University of Texas Health Science Center, San Antonio, Texas, USA. lorenzo@uthscsa.edu
Haffner
Steven M
SM
D050197:Atherosclerosis / Q000145:classification*; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000097:blood / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000145:classification / Q000175:diagnosis; D005215:Fasting; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D012372:ROC Curve; D014481:United States / Q000453:epidemiology; D014944:World Health Organization
D001786:Blood Glucose; D006442:Glycated Hemoglobin