title: Hemoglobin A1c testing alone does not sufficiently identify patients with prediabetes.
abstract: Whether hemoglobin A(1c) (HbA(1c)) values are suitable for diagnosing diabetes has been debated. We sought to assess the prevalence of elevated HbA(1c) levels in a prediabetes patient population. Oral glucose tolerance tests and HbA(1c) levels were analyzed for patients entering a diabetes prevention program between January 1, 2007, and September 13, 2009. We calculated the percentage of patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) who had HbA(1c) values in the 6.0% to 6.4% range or in the 5.7% to 6.4% range. The mean age of the 242 patients was 62 years; 64.0% were women, and 88.0% were white. Isolated IFG was detected in about 56.2% of patients and combined IFG and IGT in about 37.2%. Only 28.5% of patients had HbA(1c) values in the 6.0% to 6.4% range, whereas 65.3% had values in the 5.7% to 6.4% range. Our data suggest that reliance on HbA(1c) testing alone to identify candidates for a diabetes prevention program would miss a substantial number of eligible patients.
authors.affiliation: Division of Community Internal Medicine, Mayo Clinic, Scottsdale, AZ 85259, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Bersoux
authors.forename: Curtiss B
authors.initials: CB
authors.lastname: Cook
authors.forename: Qing
authors.initials: Q
authors.lastname: Wu
authors.forename: Mary F
authors.initials: MF
authors.lastname: Burritt
authors.forename: James S
authors.initials: JS
authors.lastname: Hernandez
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Verona
authors.forename: Marcia H
authors.initials: MH
authors.lastname: Larson
authors.forename: Carolyn S
authors.initials: CS
authors.lastname: LaRosa
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin