title: [HbA1c is not enough in screening for impaired glucose metabolism. Glucose tolerance tests are also needed, as shown in Swedish prospective epidemiological study].
abstract: An HbA1c threshold of ≥ 42 mmol/mol has been proposed to diagnose prediabetes. The sensitivity, specificity and positive predictive value of the proposed threshold for detection of individuals with prediabetes was examined in a study of 573 randomly selected individuals from Vara and Skövde. In addition, the utility of the FINDRISC questionnaire and of a fasting glucose test in combination with three short questions concerning BMI, heredity for type 2 diabetes and known hypertension was examined. Results from an oral glucose tolerance test were used as reference. The sensitivity of HbA1c and FINDRISC to detect individuals with IGT was 16 and 26 per cent respectively. Questions regarding BMI, heredity and hypertension together with a fasting glucose test yielded a sensitivity of 50%, but a lower specificity and positive predictive value. We conclude that HbA1c inefficiently detected individuals with impaired glucose tolerance and that oral glucose tolerance tests can still preferably be recommended.
authors.affiliation: Vårdcentralen Hentorp - Skövde, Sweden Medicin - Allmänmedicin Göteborg, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Hellgren
authors.affiliation: Institution of Medicine - Department of Public health and Community Medicin/Primary Health Care Göteborg, Sweden Institution of Medicine - Department of Public health and Community Medicin/Primary Health Care Göteborg, Sweden.
authors.forename: Bledar
authors.initials: B
authors.lastname: Daka
authors.affiliation: institute of Social Medicine and Global Health - Department of Clinical Sciences Malmö, Sweden institute of Social Medicine and Global Health - Department of Clinical Sciences and Global Health Malmö, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Larsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D016021:Epidemiologic Studies; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000175:diagnosis; D011446:Prospective Studies; D013548:Sweden
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin