title: Glycated hemoglobin cannot yet be proposed as a screening tool for cystic fibrosis related diabetes.
abstract: With improved life expectancy of cystic fibrosis (CF) patients, CF-related diabetes (CFRD) has become a major complication. The oral glucose tolerance test (OGTT) is the standard test to detect it. However, the use of OGTT is controversial, in addition to being a burden for patients and the treatment team. Research to find alternative ways of testing is ongoing. While some propose that glycated hemoglobin (HbA1c) may be an effective alternative, our past results suggest otherwise. A new analysis involving the OGTT and HbA1c values of 207 patients, between 2004 and 2015, proposes that the threshold of a lower value of HbA1c of ≥5.8%(39.9 mmol/mol) gives a sensitivity of 68.2% and a specificity of 60.5%. With such sensitivity to identify patients in need of an OGTT, 31.8% of CFRD diagnosis would be missed if the suggested HbA1c value of ≥5.8% was used as a screening tool to identify patients in need of OGTTs. Considering our results, we believe the HbA1c does not possess the characteristics of a suitable screening test for CFRD.
authors.affiliation: Institut de Recherches Cliniques de Montréal, Montréal, Québec, H2W 1R7, Canada; Department of Nutrition, Université de Montréal, Montréal, Québec, Canada. Electronic address: valerie.boudreau@ircm.qc.ca.
authors.forename: Valérie
authors.initials: V
authors.lastname: Boudreau
authors.affiliation: Institut de Recherches Cliniques de Montréal, Montréal, Québec, H2W 1R7, Canada; Department of Nutrition, Université de Montréal, Montréal, Québec, Canada. Electronic address: adele.coriati@ircm.qc.ca.
authors.forename: Adèle
authors.initials: A
authors.lastname: Coriati
authors.affiliation: Institut de Recherches Cliniques de Montréal, Montréal, Québec, H2W 1R7, Canada; Department of Nutrition, Université de Montréal, Montréal, Québec, Canada. Electronic address: katherine.desjardins@ircm.qc.ca.
authors.forename: Katherine
authors.initials: K
authors.lastname: Desjardins
authors.affiliation: Institut de Recherches Cliniques de Montréal, Montréal, Québec, H2W 1R7, Canada; Department of Nutrition, Université de Montréal, Montréal, Québec, Canada; Cystic Fibrosis Clinic, Centre hospitalier de l'Université de Montréal (CHUM)-Hôtel-Dieu, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada. Electronic address: remi.rabasa-lhoret@ircm.qc.ca.
authors.forename: Rémi
authors.initials: R
authors.lastname: Rabasa-Lhoret
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003550:Cystic Fibrosis / Q000097:blood / Q000150:complications*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008403:Mass Screening / Q000379:methods*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Adult; CFRD; Cystic fibrosis; Glycated hemoglobin; Oral glucose tolerance test