title: Comparison of A1C, fasting and 2-h post-load plasma glucose criteria to diagnose diabetes in Italian Caucasians.
abstract: OBJECTIVE
  The American Diabetes Association (ADA) has revised criteria for diagnosis of type 2 diabetes recommending an A1C cut point of ≥6.5% in addition to criteria based on glucose levels. We compared A1C, fasting plasma glucose (FPG) or 2-h post-challenge glucose (2-hPG) criteria for the diagnosis of diabetes in a cohort of Italian Caucasians.
  
  
  RESULTS
  A total of 1019 individuals without known diabetes completed an oral glucose tolerance test (OGTT) and had A1C measured. Moderate agreement existed for A1C and FPG criteria for diagnosis of type 2 diabetes (κ coefficient = 0.522), with 85.5% of individuals classified as not having diabetes by both A1C and FPG criteria, and 5.8% classified as having diabetes by both A1C and FPG criteria. Discordant classifications occurred for 5.5% of individuals who had an A1C ≥ 6.5% and FPG <126 mg dl(-1), and for 3.2% who had an A1C <6.5% and FPG ≥126 mg dl(-1). Modest agreement existed for A1C and 2-hPG criteria for diagnosis of type 2 diabetes (κ coefficient = 0.427), with 81.8% of individuals classified as not having diabetes by both A1C and 2-hPG criteria, and 6.0% classified as having diabetes by both A1C and 2-hPG criteria. The area under the receiver operating characteristic curve of A1C for identifying subjects with diabetes according to FPG or 2-hPG criteria was 0.856 and 0.794, respectively. Modest agreement existed for A1C and FPG and/or 2-hPG criteria for diagnosis of type 2 diabetes (κ coefficient = 0.446).
  
  
  CONCLUSIONS
  A1C ≥ 6.5% demonstrates a moderate agreement with fasting glucose and 2-hPG for diagnosing diabetes among adult Italian Caucasians subjects.
authors.affiliation: Department of Internal Medicine, University of Rome-Tor Vergata, Rome, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Marini
authors.forename: E
authors.initials: E
authors.lastname: Succurro
authors.forename: F
authors.initials: F
authors.lastname: Arturi
authors.forename: M F
authors.initials: MF
authors.lastname: Ruffo
authors.forename: F
authors.initials: F
authors.lastname: Andreozzi
authors.forename: A
authors.initials: A
authors.lastname: Sciacqua
authors.forename: R
authors.initials: R
authors.lastname: Lauro
authors.forename: M L
authors.initials: ML
authors.lastname: Hribal
authors.forename: F
authors.initials: F
authors.lastname: Perticone
authors.forename: G
authors.initials: G
authors.lastname: Sesti
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002851:Chromatography, High Pressure Liquid; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012307:Risk Factors; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin